Background: Dimethyl fumarate (DMF), a drug used for the treatment of multiple sclerosis (MS) and psoriasis, has been shown to activate the Keap1/Nrf2 antioxidant response. Nrf2 exerts pleiotropic roles in the thyroid gland; among others, single nucleotide polymorphisms (SNPs) in the gene encoding Nrf2 modulate the risk of Hashimoto's thyroiditis (HT), suggesting that pharmacological activation of Nrf2 might also be protective. However, a patient with acute exacerbation of HT after starting DMF for MS was recently reported, raising questions about the thyroidal safety of Nrf2 activators.
Methods: In a retrospective observational study, we investigated the prevalence and incidence of thyroid disorders (TD) among 163 patients with MS treated with DMF.
Results: Only 7/163 patients (4.3%) were diagnosed with functional TD; most (5/163, 3.0%) were diagnosed before DMF treatment. Functional TD were diagnosed under or after DMF in only 2 patients (1.2%). Under DMF, one patient developed transient mild hypothyroidism with negative thyroid autoantibodies. After DMF discontinuation, another patient developed hyperthyroidism due to Graves' disease. No patient developed thyroid structural disease under or after DMF.
Conclusions: The very low incidence of functional TD indicates an overall very good thyroid tolerance of DMF, arguing against screening for TD in MS patients considered for or treated with DMF, and supporting the further study of Nrf2 activators for the prevention and treatment of TD.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9138003 | PMC |
| http://dx.doi.org/10.3390/antiox11051015 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outcomes of Importance to Patients Living With Cutaneous Chronic Graft-vs-Host Disease.
JAMA Dermatol
January 2025
Department of Dermatology, University of Pennsylvania, Philadelphia.
Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.
Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.
Clinical Perspectives on the Pathophysiology of Facial Synkinesis: A Narrative Review.
JAMA Otolaryngol Head Neck Surg
January 2025
Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas.
Importance: Facial synkinesis refers to pathologic cocontraction and baseline hypertonicity of muscles innervated by the facial nerve, commonly attributed to the aberrant regeneration of nerve fibers following injury. The pathomechanism and optimal treatment of facial synkinesis remain unclear. The goal of this review is to highlight current understanding of the epidemiology, pathophysiology, clinical presentation, assessment, and treatment of facial synkinesis.
View Article and Find Full Text PDFArtificial Intelligence-Enhanced Electrocardiography for Prediction of Incident Hypertension.
JAMA Cardiol
January 2025
National Heart and Lung Institute, Imperial College London, United Kingdom.
Importance: Hypertension underpins significant global morbidity and mortality. Early lifestyle intervention and treatment are effective in reducing adverse outcomes. Artificial intelligence-enhanced electrocardiography (AI-ECG) has been shown to identify a broad spectrum of subclinical disease and may be useful for predicting incident hypertension.
View Article and Find Full Text PDFProgrammable Food-Derived Peptide Coassembly Strategies for Boosting Targeted Colitis Therapy by Enhancing Oral Bioavailability and Restoring Gut Microenvironment Homeostasis.
ACS Nano
January 2025
Jilin Provincial Key Laboratory of Nutrition and Functional Food, College of Food Science and Engineering, Jilin University, Changchun 130062, China.
Orally targeting nanostrategies of multiple nutraceuticals have attracted increasing attention in ulcerative colitis (UC) therapy for superior patient compliance, cost-effectiveness, and biocompatibility. However, the actual targeting delivery and bioefficacy of nutraceuticals are extremely restricted by their poor solubility, interior gastrointestinal retention, and base permeability. Herein, we developed controllable colon-targeting nanoparticles (NPs) composed of a quaternary ammonium chitosan (HTCC) shell and succinic acid-modified γ-cyclodextrin (SACD) core for precise UC treatment.
View Article and Find Full Text PDFDialogical and Relational Taster Training (DARTT): Service User, Carer & Public Perception.
Community Ment Health J
January 2025
North East London NHS Foundation Trust, Research and Development Department, Goodmayes Hospital, 1st Floor Maggie Lilley Suite, Barley Lane, Ilford, IG3 8XJ, UK.
In response to the paucity of training in therapeutic relationships and relational care for mental health clinicians, a new three-day training programme has been developed called Compassionate and Relational Enquiry (CARE). A condensed version of this training was recently delivered to mental health service users, carers and the public during a one-day online taster session- named Dialogical And Relational Taster Training (DARTT) - to understand their perception of this training programme. 21 people took part in this taster training day and subsequently completed a survey about their impression of different elements of the training.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!