How does Vumerity work?

Vumerity (diroximel fumarate) is a delayed-release capsule used to treat relapsing forms of the autoimmune disorder multiple sclerosis (MS).

Vumerity contains diroximel fumarate. Diroximel fumarate is rapidly converted in the body to monomethyl fumarate (MMF), which is the same active metabolite Tecfidera (dimethyl fumarate) has.

It is not yet known exactly how Vumerity works - what its mechanism of action is - in the treatment of MS.

MS is a condition in which a person’s own immune system mistakenly attacks the central nervous system (CNS), causing inflammation and damage to myelin, which forms fatty sheaths around nerve cells to protect them.

It is thought that Vumerity may modulate the immune system to reduce the amount of inflammation it causes. It is also thought to have anti-oxidative properties that help protect key parts of the CNS from damage, including the brain and spinal cord.

MMF, the active metabolite of Vumerity, activates the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway. The Nrf2 protein’s antioxidant properties are thought to reduce damage caused by oxidative stress, which contributes to the nerve damage caused by MS.

MMF also activates the hydroxycarboxylic acid receptor 2 (HCAR2). This interaction with HCAR2 results in anti-inflammatory activity, especially in immune cells.

It’s unclear whether it plays a role in its ability to help in the treatment of MS, but MMF is also a nicotinic acid receptor agonist.