Fumaderm and hormone injections

[jiml]

Of course on point #2 of Fred, He thinks he is going the correct proven road with MTX but he doesn't know how dangerous it is. Ask him if he will start using it for two weeks.
It is the DMF that is not dangerous.

I think I'm misunderstanding that comment.  

But just to clarify I wasn't suggesting for one minute Jim goes back onto Methotrexate. I was just saying that no matter what we think they have to follow the rules.

True, but the rules do not state that you are allowed to place the patient deliberately in a more dangerous situation that is necessary.

I have printed out the document that Bill pointed to as it does, rather knock their argument, to put me on mtx

A question for Caroline ....is Fumaderm an immunosuppressant drug like methotrexate is?

[Caroline]

Of course on point #2 of Fred, He thinks he is going the correct proven road with MTX but he doesn't know how dangerous it is. Ask him if he will start using it for two weeks.
It is the DMF that is not dangerous.

I think I'm misunderstanding that comment.  

But just to clarify I wasn't suggesting for one minute Jim goes back onto Methotrexate. I was just saying that no matter what we think they have to follow the rules.

True, but the rules do not state that you are allowed to place the patient deliberately in a more dangerous situation that is necessary.

I have printed out the document that Bill pointed to as it does, rather knock their argument, to put me on mtx

A question for Caroline ....is Fumaderm an immunosuppressant drug like methotrexate is?

Jim,
There are several/many studies on DMF. But the total conclusions remain vague. It is said that is has an immunomodulative... blabla effect and that it seems to affect IL-6 end IL-12 and in the same studies it is said that this conclusion is opposite from other studies.
It is also said that it modulates the IL-17 and I have even heard of IL-23. (whatever those different receptors are for).

Quote:

---

In our study, we demonstrate that DMF inhibits MSK1 activation through its upstream protein ERK1/2 (Fig. 7, Point 2). Our observation is in conflict with a study published by Gesser et al. (47) where DMF inhibits MSK1 without affecting p38 or ERK1/2. [/qt] (this stupid endquote does not work). [/qt]

Just picked out of some study. So that brings us....eh

[qt]In conclusion, we demonstrate that DMF inhibits DC maturation and function, and subsequently, suppresses Th1 and Th17 cell differentiation. Further, our molecular data demonstrate that DMF exerts its effect via suppression of both p65 and ERK1/2-MSK1 signaling. Our study provides an important mechanism for the action of DMF in modulating inflammation and provides insight into pathways that are effective targets for therapeutic intervention in inflammatory diseases

lots of the auto immune diseases are inflammatory, P, MS, Crohns, etc.

The article I got it from is called: "Dimethyl Fumarate Inhibits Dendritic Cell Maturation via Nuclear Factor κB (NF-κB) and Extracellular Signal-regulated Kinase 1 and 2 (ERK1/2) and Mitogen Stress-activated Kinase 1 (MSK1) Signaling"
It is so complex, with so many factors in it that I think it is a miracle that they got a conclusion out of it.
Still I think that my thread on DMF shows a lot of the why it works and is readable bij doctors and patients. Dimethylfumarates and Psoriasis

Specifically this post RE: Dimethylfumarates and Psoriasis, tells something about the misconception of the dermatologists and refers to the studie of Litjens, I don't have access to those studies, but doctors should have that access.

[jiml]

Thanks Caroline for your research .... I have also been researching and there does not seem to be anything difinitive that I can present to the rheumatologist

There do seem to be a lot of publications on DMF in the treatment of psoriasis but I gave been unable to find anything that refers to its use for psoriatic arthritis

Although your article here does mention its use for inflammatory disease ...thank you

[Bill]

This article might be of use, Jim.

Treating rheumatic patients with a malignancy

What I took from it is that if there is any doubt about the risk an oncologist should be consulted.

[jiml]

This article might be of use, Jim.

Treating rheumatic patients with a malignancy

What I took from it is that if there is any doubt about the risk an oncologist should be consulted.

Thanks Bill I will read it and print it out to take with me

[Bill]

< The 200 mg/kg/day dose of DMF (the only dose tested in the arthritis model and the dose showing elimination of clinical symptoms in the EAE model) was slightly higher than the human dose (~3 fold based on plasma AUC for a different strain, or ~5 fold based on body surface area (mg/m2)), but some anti-inflammatory activity in vivo was observed at lower doses. >

It is contained in a document submitted to the TGA by Biogen. I think that the anti-inflammatory and neuro-protective effects of DMF has led to investigation of its use for traumatic brain injuries.

[Kat]

I don't reallly have much to add Jim but wanted to comment anyway.

I'd stick with telling them you did not tolerate Methotrexate well and have already tried it. If they are insistent, perhaps ask them for other options and go from there. Sorry for your wasted afternoon at the doctor's office, I know those all to well. Hoping July brings you more answers.

[jiml]

I don't reallly have much to add Jim but wanted to comment anyway.  

I'd stick with telling them you did not tolerate Methotrexate well and have already tried it.  If they are insistent, perhaps ask them for other options and go from there.  Sorry for your wasted afternoon at the doctor's office, I know those all to well.  Hoping July brings you more answers.

Thanks Kat it was frustrating not being able to talk to the organ grinder this time I'm sure if I had seen him I could have had a reasoned arguement with him and possibly come away with the result I wanted. But it's difficult having a conversation through an intermediary

I have been armed with some great information regarding methotrexate and dormant cancers as mine is. Which I shall throw into the pot during my next altercation in July if I need to

Thanks for your reply it's always very welcome

[jiml]

Just been for my monthly Fumaderm blood test and my levels are still good, my skin is still virtually clear after over 4 years on Fumaderm

My  levels from February are
Neutrophils 4.97   Normal 2.00-7.00
Lymphocytes 1.09. Normal 1.00- 3.00

March levels

Neutrophils 3.40
Lymphocytes 1.46

April levels

Neutrophils 3.34
Lymphocytes 1.27

So no real trend up or down but little fluctuations ....I'm happy with those results

Each of those months my kidney and liver functions were good and within normal levels..I won't bore you with all the figures

Booked my next hormone injection for my prostate cancer for next month...but the blood test for that shows almost untraceable.

[Bill]

Very safe at those levels, Jim. Good result.