Case of PML in non-MS patient using Tecfidera-like drug

[SuzE-Q]

Unique case of non-MS patient using Tecfidera-like substance who develops PML despite having normal WBC count, historically thought to put one at increased risk:

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[agate]

Thanks for posting this. There were two letters (not articles) in the latest issue of the New England Journal of Medicine--one describing the PML death of the MS patient on Tecfidera, the other describing the psoriasis patient who died of PML while on the Tecfidera-like drug in the article you posted.

One of the 3 authors of the second letter is employed by Biogen Idec, makers of Tecfidera.

The last paragraph in the article by Nieuwkamp et al. (the psoriasis case) sounds a note of caution:

Since the number of patients who are being treated with DMF is rapidly increasing after approval of delayed-release DMF (Tecfidera) as first-line treatment for relapsing–remitting multiple sclerosis, our case raises important questions with respect to safety monitoring. Although more than 100,000 patients with multiple sclerosis have been treated with Tecfidera since 2013, the safety profile for long-term treatment is unknown. On October 22, 2014, the first case of PML in a patient receiving Tecfidera was reported; this patient had persistent, severe lymphocytopenia. Our case shows that PML can develop during treatment with compounded DMF in patients in whom reduced lymphocyte counts are less severe than those in cases that have been reported previously.

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[SuzE-Q]

Thanks agate for that additional info. I hope these numbers don't rise with more MSers taking it, and hopefully this psoriasis patient's history may help shed light on exact risk factors for PML.