Latest research on BG-12

Dimethyl fumarate is an anti-inflammatory. It is indicated for multiple sclerosis patients with relapsing forms and is also being investigated for the treatment of psoriasis. The mechanism of action of dimethyl fumarate in multiple sclerosis is not well understood. It is thought to involve dimethyl fumarate degradation to its active metabolite monomethyl fumarate (MMF) then MMF up-regulates the Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway that is activated in response to oxidative stress. Dimethyl fumarate is marketed under the brand name Tecfidera.

BG-12 indications

In these trials, BG-12 was well tolerated, the most common side effects being characterized by redness, gastrointestinal symptoms, and headaches. [source, 2016]
However, the most notable effect was observed when MRI endpoints were evaluated; BG-12 reduced the numbers of new or enlarging hyperintense lesions on T2-weighted images by up to 85%, and the number of gadolinium-enhanced lesions by up to 94%. [source, 2015]
The results showed that the estimated treatment effects of both BG-12 doses tested (240 mg two or three times daily) were equivalent to or better than those achieved with GA in terms of efficacy endpoints. [source, 2015]
A current therapy for relapsing MS is oral dimethyl fumarate (DMF; Tecfidera), a methyl ester of fumaric acid that is rapidly hydrolyzed to its active metabolite monomethyl fumarate (MMF), and shown to have a significant effect on relapse rate and time to progression in phase III clinical trials of MS (79, 80). [source, 2015]
Dimethyl fumarate (DMF), an essential member of fumaric acid ester (FAE) family, is the active ingredient of BG-12, which has been offered as an effective oral treatment option for patients with relapsing remitting multiple sclerosis (RRMS) [62]. [source, 2015]
By systematically combining results from the identified studies, our goal is to provide precise estimate of a treatment effect and therefore strengthen the currently available evidence of BG-12 effectiveness. [source, 2014]
Two phase III RCTs (DEFINE; Determination of the Efficacy and Safety of Oral Fumarate in Relapsing–Remitting MS [15-19] and CONFIRM; Comparator and an Oral Fumarate in Relapsing–Remitting MS [20-24]) evaluated the effectiveness of BG-12 monotherapy in adult patients with RRMS, in comparison with placebo. [source, 2014]
However, post hoc evaluation showed a significant treatment effects of BG-12 (both dosages) compared to glatiramer acetate for the number of new or enlarging T2 lesions on MRI [20]. [source, 2014]
Our systematic review include data from full text studies evaluating the effectiveness of BG-12 in the treatment of RRMS, that have been published in 2013. [source, 2014]
However, the available data described in the above-mentioned reviews suggest that BG-12 could be more effective in reducing relapses and slowing the progression of MS than commonly prescribed injectable agents, such as GA, or INF beta. [source, 2014]