Diroximel fumarate for relapsing-remitting multiple sclerosis

Diroximel fumarate is in clinical development for the treatment of relapsing-remitting Multiple Sclerosis (MS). MS is an autoimmune disease, meaning the body’s own immune cells (which usually fight infection) attack and damage the nerves and brain. This causes a range of issues including problems with walking, balance, memory and thinking as well as pain, tiredness and many other symptoms. In most people the symptoms of MS follow a ‘relapsing and remitting pattern’ where the disease relapses (and symptoms worsen) and then remits (where the symptoms improve).
Diroximel fumarate is designed to rapidly convert to monomethyl fumarate (MMF) in the body. MMF is known to activate a protein called Nrf2. Among other effects, Nrf2 is thought to have antioxidant properties, and when activated should reduce damage from oxidative stress. In MS, inflammation and oxidative stress contribute to damage to nerve cells and the myelin sheath that insulates nerve fibres. By activating the Nrf2 pathway, diroximel fumarate may reduce or slow the progressive damage to nerve cells. If licensed, diroximel fumarate as an oral formulation may offer an additional treatment option for relapsing-remitting MS with fewer gastrointestinal side effects than currently available therapies.