BACKGROUND: Fumaric acid esters (FAEs) have been used for over 30 years in the management of psoriasis. OBJECTIVES: To determine drug survival of FAEs in patients with psoriasis, treatment-limiting adverse drug events and the range of effective drug doses. METHODS: A retrospective, single-centre study assessing all patients commenced on FAEs between October 2003 and July 2012. Demographic data, length of treatment, reasons for discontinuation of FAEs, side-effects and range of doses were recorded. RESULTS: Two hundred and forty-nine patients [160 (64%) male] were included. The mean age at which FAEs were commenced was 44·5 years (range 17-82 years). The mean length of treatment was 28 months (range 1 week to 106 months). In patients who were commenced on FAEs ≥ 4 years before inclusion in this study, the 4-year drug survival was 60% (64/107). FAEs were discontinued in 146/249 patients (59%); this was due to lack of efficacy in 59/146 (40%) and gastrointestinal upset in 39/146 (27%). A very low dose of FAEs (< 240 mg daily) was successful in maintaining control of psoriasis in 26 (10%) patients. The mean treatment duration of these patients was 64 months (range 32-106 months). CONCLUSIONS: Fumaric acid esters have a 4-year drug survival rate of 60%, which compares favourably with reported 4-year survival rates of 40% for etanercept and adalimumab and 70% for infliximab. Longer drug survival is more likely in the significant subgroup of patients in whom a very low dose of FAEs is sufficient to control disease. The reasons for this are unclear.
BACKGROUND:Fumaric acid esters (FAEs) have been used for over 30 years in the management of psoriasis. OBJECTIVES: To determine drug survival of FAEs in patients with psoriasis, treatment-limiting adverse drug events and the range of effective drug doses. METHODS: A retrospective, single-centre study assessing all patients commenced on FAEs between October 2003 and July 2012. Demographic data, length of treatment, reasons for discontinuation of FAEs, side-effects and range of doses were recorded. RESULTS: Two hundred and forty-nine patients [160 (64%) male] were included. The mean age at which FAEs were commenced was 44·5 years (range 17-82 years). The mean length of treatment was 28 months (range 1 week to 106 months). In patients who were commenced on FAEs ≥ 4 years before inclusion in this study, the 4-year drug survival was 60% (64/107). FAEs were discontinued in 146/249 patients (59%); this was due to lack of efficacy in 59/146 (40%) and gastrointestinal upset in 39/146 (27%). A very low dose of FAEs (< 240 mg daily) was successful in maintaining control of psoriasis in 26 (10%) patients. The mean treatment duration of these patients was 64 months (range 32-106 months). CONCLUSIONS:Fumaric acid esters have a 4-year drug survival rate of 60%, which compares favourably with reported 4-year survival rates of 40% for etanercept and adalimumab and 70% for infliximab. Longer drug survival is more likely in the significant subgroup of patients in whom a very low dose of FAEs is sufficient to control disease. The reasons for this are unclear.
Authors: Juul M P A van den Reek; Wietske Kievit; Robert Gniadecki; Jelle J Goeman; Jeffrey Zweegers; Peter C M van de Kerkhof; Marieke M B Seyger; Elke M G J de Jong Journal: J Invest Dermatol Date: 2015-07 Impact factor: 8.551
Authors: K J Mason; S Williams; Z Z N Yiu; K McElhone; D M Ashcroft; C E Kleyn; Z K Jabbar-Lopez; C M Owen; N J Reynolds; C H Smith; N Wilson; R B Warren; C E M Griffiths Journal: Br J Dermatol Date: 2019-03-27 Impact factor: 9.302
Authors: G E van der Kraaij; D M W Balak; C I Busard; O D van Cranenburgh; Y Chung; R J B Driessen; M de Groot; E M G J de Jong; P M J H Kemperman; W J A de Kort; S A Karsch; A Lamberts; L L A Lecluse; P P M van Lümig; S P Menting; E P Prens; J M P A van den Reek; M M B Seyger; H B Thio; W R Veldkamp; M Wakkee; A Nast; A Jacobs; S Rosumeck; P I Spuls Chair Journal: Br J Dermatol Date: 2019-01 Impact factor: 9.302