Fumaric Acid Esters for Psoriasis

Title: Fumaric acid esters for severe psoriasis: a retrospective review of 58 cases.
: Harries MJ, et al.
Publication: Br J Dermatol. 2005 Sep;153(3):549-51.

Fumaric acid esters have been used to treat severe psoriasis in northern Europe for over 20 years, however the treatment is not licensed in the United Kingdom. The authors wanted to review the efficacy and tolerability of fumaric acid esters in one UK center.

Between June 1999 and October 2003, 58 patients (25 women and 33 men) were treated with fumaric acid esters. 55 (95%) of the 58 patients had previously used other psoriasis treatment. Most of them even used two or more treatments.

With fumaric acid esters, the authors found the following result:

  • 55% of the patients showed improvement in their psoriasis. 10 of them were rated “clear” or “virtually clear”.
  • 28% had no improvement
  • 16% had worsening of the disease

The authors noted that side effects were common and were reported in 66% of the patients. These mainly consisted of:

  • Abdominal pain (61%)
  • Diarrhea (55%)
  • Flushing or redness (45%)
  • Nausea (21%)
  • Malaise (15%)

These side effects caused discontinuation of treatment in 15 patients after an average treatment period of 4.7 months.

Lymphocytopenia (lymphopenia or reduction in the number of white blood cells) developed in 57% of the patients. This caused treatment to be stopped in one patient.

The authors concluded that fumaric acid esters could be an effective treatment in patients with severe psoriasis, even in those who previously had other treatments that failed.

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