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New drug: dimethyl fumarate to treat psoriasis


Dimethyl fumarate (Skilarence®) was newly registered in 2017 for the treatment of psoriasis. This is not a new drug, as it has been available as an unlicensed product for decades. After the registration, the drug was made more expensive. Its short-term effectiveness for the treatment of psoriasis has now been proven in randomised research. There have been no studies of its effectiveness in the longer term. Its frequent gastrointestinal adverse effects limit the suitability of dimethyl fumarate.


  • Dimethyl fumarate (DMF) reduces psoriasis symptoms in the short term. For every five patients treated, one additional patient shows a 75% or greater reduction in the number of lesions, or is virtually free of psoriasis symptoms. 
  • The long-term effectiveness of this drug has not been investigated.
  • Patients experience considerable discomfort, particularly from gastrointestinal adverse effects, and dropout rates due to adverse effects are high.
  • In order to reduce the risk of serious infections due to leukopenia and lymphopenia, patients using DMF need to have a full blood count every three months.
  • The registered product is twice as expensive as the previously available pharmacy preparations.
  • In view of the lack of data on its long-term effect and of studies comparing it with other psoriasis drugs, Ge-Bu rates this drug as ‘+/-’.

  1. Productinformatie Skilarence®. Via: www.ema.europa.eu/ema/.
  2. Informatorium Medicamentorum. Den Haag: KNMP, 2018. Via: https://www.knmp.nl/producten/knmp-kennisbank.
  3. Goodman&Gilman’s The pharmacological basis of therapeutics 13th edition. Brunton LL, Knollmann BC, Hilal-Dandan R. New York: Mc Graw Hill Medical, 2018.
  4. Mrowietz U, Szepietowski JC, Loewe R, van de Kerkhof P, Lamarca R, Ocker WG, Tebbs VM, Pau-Charles I. Efficacy and safety of LAS41008 (dimethyl fumarate) in adults with moderate-to-severe chronic plaque psoriasis: a randomized, double-blind, Fumaderm®- and placebo-controlled trial (BRIDGE).  Br J Dermatol 2017 Mar:176(3);615–23.
  5. Atwan A, Ingram JR, Abbott R, Kelson MJ, Pickles T, Bauer A, Piguet V. Oral fumaric acid esters for psoriasis. Cochrane Database of Syst Rev 2015(8): CD010497.
  6. Nederlandse Vereniging voor Dermatologie en Venereologie. Psoriasis multidisciplinaire evidence based richtlijn (2017). Via: http://www.nvdv.nl/wp-content/uploads/2014/08/190325_definitieve-versie-richlijnherziening-psoriasis-2017.pdf
  7. Van Peet PG, Spuls PhI, Ek JW, Lantinga H, Lecluse LLA, Oosting AJ, Visser HS, Burgers JS, Geijer RMM, Kolnaar BGM, Eizenga WH. NHG-Standaard Psoriasis(derde herziening). Huisarts Wet 2014;57(3):128-35.
  8. Landeck L, Asadullah K, Amasuno A, Pau-Charles I, Mrowietz U. Dimethyl fumarate (DMF) vs. monoethyl fumarate (MEF) salts for the treatment of plaque psoriasis: a review of clinical data. Arch Dermatol Res. 2018 Aug;310(6):475-483.
  9. Fallah Arani S, Neumann H, Hop WC, Thio HB. Fumarates vs. methotrexate in moderate to severe chronic plaque psoriasis: a multicentre prospective randomized controlled clinical trial. Br J Dermatol. 2011 Apr;164(4):855-61.
  10. Risico-minimalisatiemateriaal betreffende dimethylfumaraat voor zorgverleners. Via: www.geneesmiddeleninformatiebank.nl
  11. Balak DM. Dimethyl fumarate finally coming of age. Br J Dermatol 2017 Mar; 176(3):563–64.
  12. Standpunt geregistreerde en niet-geregistreerde fumaraten. NVDV 2019. Via: http://www.nvdv.nl/wp-content/uploads/2015/05/2019-03-18-Standpunt-geregistreerde-en-niet-geregistreerde-fumaraten.pdf.

The literature refers to the Dutch text

Authors

  • dr L.M.L. Stolk