Monomethyl fumarate

Monomethyl fumarate (MMF) is an ester derived from fumaric acid. It is used in the treatment of multiple sclerosis and psoriasis, and is marketed under the brand names Tecfidera, among others.

Chemistry

MMF is a methyl ester of fumaric acid. It is a white crystalline solid that is soluble in water. The chemical formula for MMF is C5H6O4.

Medical uses

MMF is used in the treatment of relapsing-remitting multiple sclerosis (RRMS). It is also used in the treatment of psoriasis, a chronic skin condition.

Multiple sclerosis

In the treatment of RRMS, MMF is thought to have immunomodulatory effects. It is believed to inhibit the migration of white blood cells into the brain, reducing inflammation and damage to the neural tissue.

Psoriasis

In the treatment of psoriasis, MMF is thought to work by inhibiting the proliferation of skin cells, reducing the formation of psoriatic plaques.

Side effects

Common side effects of MMF include flushing, diarrhea, nausea, and abdominal pain. In rare cases, it can cause lymphopenia, a decrease in the number of lymphocytes in the blood.

Pharmacology

MMF is rapidly converted in the body to monomethyl fumarate, its active metabolite. It is thought to exert its effects by activating the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway, which plays a key role in the cellular response to oxidative stress.

History

MMF was first approved for the treatment of RRMS in the European Union in 2013, and in the United States later the same year.

See also

• Fumaric acid
• Multiple sclerosis
• Psoriasis