Low energy levels on fumaderm

[jiml]

It was the case of the patient with a 0.8 count getting PML that caused the concern. There is also concern that the JC virus may also act more slowly and cause  dementia over a longer period. I stress this is speculative, but now that DMF is being used on large numbers of patients the uncommon side effects can be a problem. Personally I find DMF to be neuroprotective, but I wouldn't go as far as saying that the caution is an over-reaction. It would be nice if MTX were treated with the same level of concern instead of presenting statistical marvels to show how great it is.

I think it's better to warn and point out facts, if they are available and then let people make up their own minds. How to deal with them
I know the cases are rare but that doesn't mean you should put yourself at risk by maintaining a low lymphocyte count, and not take any action i.e. Reduce dose or retest blood levels .

I agree that there should be more warning about methotrexate. But the problems caused by that are more or less ignored