Fumaric acid esters in the management of psoriasis

Deepak MW Balak Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands Abstract: Fumaric acid esters (FAE) are small molecules with immunomodulating, anti-inflammatory, and anti-oxidative effects. FAE were introduced as a systemic psoriasis treatment in 1959 and empirically...

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Autor principal:	Balak DMW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/8b94da7dbf4342a1a9b04bbb128e5bd5
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spelling	oai:doaj.org-article:8b94da7dbf4342a1a9b04bbb128e5bd52021-12-02T07:45:59ZFumaric acid esters in the management of psoriasis2230-326Xhttps://doaj.org/article/8b94da7dbf4342a1a9b04bbb128e5bd52015-01-01T00:00:00Zhttp://www.dovepress.com/fumaric-acid-esters-in-the-management-of-psoriasis-peer-reviewed-article-PTThttps://doaj.org/toc/2230-326X Deepak MW Balak Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands Abstract: Fumaric acid esters (FAE) are small molecules with immunomodulating, anti-inflammatory, and anti-oxidative effects. FAE were introduced as a systemic psoriasis treatment in 1959 and empirically developed further between 1970 and 1990 in Germany, Switzerland, and the Netherlands. The development of FAE as psoriasis treatment did not follow the traditional drug development phases. Nonetheless, in 1994 FAE were approved in Germany for the treatment of severe plaque psoriasis. FAE are currently one of the most commonly used treatments in Germany, and FAE are increasingly being used as an unlicensed treatment in several other European countries. To date, six randomized controlled trials and 29 observational studies have evaluated FAE in a combined total of 3,439 patients. The efficacy and safety profile of FAE is favorable. About 50%–70% of patients achieve at least 75% improvement in psoriasis severity after 16 weeks of treatment. Common adverse events of FAE include gastrointestinal complaints and flushing symptoms, which lead to treatment discontinuation in up to 40% of patients. Lymphocytopenia, eosinophilia, and proteinuria are commonly observed during FAE treatment, but rarely require treatment discontinuation. The long-term safety profile of continuous FAE treatment is favorable without an increased risk for infections, malignancies, or other serious adverse events. There are no known drug-interactions for FAE. The 2009 European evidence-based S3-guidelines on psoriasis treatment recommend FAE and suggest it as a first-line systemic treatment for moderate-to-severe plaque psoriasis. This review is aimed to give an overview of FAE treatment in the management of psoriasis. Keywords: fumaric acid esters, fumarates, dimethyl fumarate, Fumaderm, psoriasis, systemic treatmentBalak DMWDove Medical PressarticleDermatologyRL1-803ENPsoriasis: Targets and Therapy, Vol 2015, Iss default, Pp 9-23 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dermatology RL1-803
spellingShingle	Dermatology RL1-803 Balak DMW Fumaric acid esters in the management of psoriasis
description	Deepak MW Balak Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands Abstract: Fumaric acid esters (FAE) are small molecules with immunomodulating, anti-inflammatory, and anti-oxidative effects. FAE were introduced as a systemic psoriasis treatment in 1959 and empirically developed further between 1970 and 1990 in Germany, Switzerland, and the Netherlands. The development of FAE as psoriasis treatment did not follow the traditional drug development phases. Nonetheless, in 1994 FAE were approved in Germany for the treatment of severe plaque psoriasis. FAE are currently one of the most commonly used treatments in Germany, and FAE are increasingly being used as an unlicensed treatment in several other European countries. To date, six randomized controlled trials and 29 observational studies have evaluated FAE in a combined total of 3,439 patients. The efficacy and safety profile of FAE is favorable. About 50%–70% of patients achieve at least 75% improvement in psoriasis severity after 16 weeks of treatment. Common adverse events of FAE include gastrointestinal complaints and flushing symptoms, which lead to treatment discontinuation in up to 40% of patients. Lymphocytopenia, eosinophilia, and proteinuria are commonly observed during FAE treatment, but rarely require treatment discontinuation. The long-term safety profile of continuous FAE treatment is favorable without an increased risk for infections, malignancies, or other serious adverse events. There are no known drug-interactions for FAE. The 2009 European evidence-based S3-guidelines on psoriasis treatment recommend FAE and suggest it as a first-line systemic treatment for moderate-to-severe plaque psoriasis. This review is aimed to give an overview of FAE treatment in the management of psoriasis. Keywords: fumaric acid esters, fumarates, dimethyl fumarate, Fumaderm, psoriasis, systemic treatment
format	article
author	Balak DMW
author_facet	Balak DMW
author_sort	Balak DMW
title	Fumaric acid esters in the management of psoriasis
title_short	Fumaric acid esters in the management of psoriasis
title_full	Fumaric acid esters in the management of psoriasis
title_fullStr	Fumaric acid esters in the management of psoriasis
title_full_unstemmed	Fumaric acid esters in the management of psoriasis
title_sort	fumaric acid esters in the management of psoriasis
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/8b94da7dbf4342a1a9b04bbb128e5bd5
work_keys_str_mv	AT balakdmw fumaricacidestersinthemanagementofpsoriasis
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Fumaric acid esters in the management of psoriasis

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