Diroximel fumarate itself is not present in the bloodstream. MMF reaches highest concentrations in the blood plasma 2.5 to 3 hours after ingestion. When in the bloodstream, 27 to 45% are bound to plasma proteins.MMF is further metabolized to fumarate, citrate and glucose, ultimately entering the citric acid cycle and being broken down to carbon dioxide (CO2). About 60% of the substance leave the body as CO2 via the lungs, 15.5% are eliminated with the urine (according to another source, less than 0.3%), and 0.9% are eliminated with the faeces. The terminal half-life is one hour.HES is eliminated mainly with the urine (58 to 63%). Chemistry
The substance is a white to off-white powder. It is slightly soluble in water; that is, its solubility is between 1:100 and 1:1000. The molecule is achiral. The double bond of the fumarate moiety has E configuration. History
This drug was formulated by Alkermes in collaboration with Biogen. Society and culture
Legal status
Diroximel fumarate was approved for medical use in the United States in October 2019.On 16 September 2021, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Vumerity, intended for the treatment of adults with relapsing remitting multiple sclerosis. The applicant for this medicinal product is Biogen Netherlands B.V. It was approved for medical use in the European Union in November 2021. References
External links
"Diroximel fumarate". Drug Information Portal. U.S. National Library of Medicine.
Acute lymphoblastic leukemia (ALL) is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes. Symptoms may include feeling tired, pale skin color, fever, easy bleeding or bruising, enlarged lymph nodes, or bone pain. As an acute leukemia, ALL progresses rapidly and is typically fatal within weeks or months if left untreated.In most cases, the cause is unknown. Genetic risk factors may include Down syndrome, Li-Fraumeni syndrome, or neurofibromatosis type 1. Environmental risk factors may include significant radiation exposure or prior chemotherapy. Evidence regarding electromagnetic fields or pesticides is unclear. Some hypothesize that an abnormal immune response to a common infection may be a trigger. The underlying mechanism involves multiple genetic mutations that results in rapid cell division. The excessive immature lymphocytes in the bone marrow interfere with the production of new red blood cells, white blood cells, and platelets. Diagnosis is typically based on blood tests and bone marrow examination.ALL is typically treated initially with chemotherapy aimed at bringing about remission. This is then followed by further chemotherapy typically over a number of years. Treatment usually also includes intrathecal chemotherapy since systemic chemotherapy can have limited penetration into the central nervous system and the central nervous system is a common site for relapse of acute lymphoblastic leukemia.Treatment can also include radiation therapy if spread to the brain has occurred. Stem cell transplantation may be used if the disease recurs following standard treatment.