How do Vumerity and Tecfidera compare for multiple sclerosis (MS)?

Vumerity (diroximel fumarate) and Tecfidera (dimethyl fumarate) are medications used to treat multiple sclerosis (MS). Their key similarities and differences are outlined below.

Key similarities between Vumerity and Tecfidera:

• Uses. Vumerity and Tecfidera are both used for the treatment of relapsing forms of MS, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
• Dosage forms. Vumerity and Tecfidera both come in the form of a delayed-release capsule.
• Active metabolite. Vumerity and Tecfidera have the same active metabolite called monomethyl fumarate (MMF), which is a modified form of the drug produced when it is metabolized by the body.
  
  The ‘active’ metabolite, as the name suggests, is responsible for the drug’s therapeutic effect or ability to help treat MS.
  
  Because Vumerity and Tecfidera have the same active metabolite, Biogen was able to gain FDA approval for Vumerity in 2019, using clinical trial data for Tecfidera, which was approved in 2013.

Key difference between Vumerity and Tecfidera:

• Chemical structure. Vumerity contains diroximel fumarate, which has the chemical name 2-Butenedioic acid (2E)-, 1-[2-(2,5-dioxo-1-pyrrolidinyl)ethyl] 4-methyl ester and the molecular formula is C₁₁H₁₃NO₆.
  
  Tecfidera contains dimethyl fumarate, which has the chemical name 2-Butenedioic acid (2E))-, 1,4,-dimethyl ester and the molecular formula C₆H₈O₄.
• Side effects. Treatment with vumerity causes less severe gastrointestinal (GI) events and results in fewer days of self-reported GI symptoms compared with treatment with Tecfidera. It also causes fewer GI adverse events and fewer people stop taking it because of GI adverse events.

Bottom line

Vumerity and Tecfidera are administered in the same way and used to treat the same condition, MS. They also have the same active metabolite, which means that they have the same therapeutic effect - work the same way - in people with MS.

However, Vumerity and Tecfidera do have different chemical structures and Vumerity is better tolerated and causes fewer gastrointestinal problems compared with Tecfidera.