Fumaderm and kidney problems

[Bill]

Thank you so much. As a user of DMF I am very interested in avoiding problems, but I scratch my head wondering why the damage from the cyclosporin was not properly evaluated and why fumaderm was started straight away. From the guidelines that I found:

<FAE therapy is contraindicated in patients with severe concomitant conditions including severe or chronic gastrointestinal disease or kidney disease, >

and

<Current guidelines recommend a gradual increase in oral FAE dose to determine each patient's maximum tolerable dose, and advise against concomitant use of topical fumaric acid derivatives to avoid exceeding the maximum dose through percutaneous absorption.[74,75] When used according to these guidelines in controlled clinical trials, no nephrotoxicity has been observed.[74,87] Nevertheless, sufficient fluid intake should be encouraged during FAE therapy,[75,82] and renal function should be monitored throughout treatment.>

So I am of the opinion that the damage was caused by cyclosporin and the Fumaderm was used against the guidelines. However, plenty of testing was done and treatment was ceased as soon as a problem was found. It may be a case of Fumaderm being the only drug available that did not entail long NHS waiting times as Grizzly has been unhappily enduring. Jim has been on Fumaderm for several years with great results and no harm, yet the guidelines I read would have excluded him from treatment also!

Thanks again for sharing your information and I hope all goes well.