Skyrizi vs Fumaderm for psoriasis

[Caroline]

One thing I have always wondered is why DMF is not more widely available and used for treatment (psoriasis) since it works so well for some.  I'm venturing out that it's comparisons such as the one conducted by Skyrizi and they are indeed most likely biased if it's from the drug manufacturer but it does make one question why DMF isn't doing it's own comparisons and blowing everyone else away by the results.  But also I'm paying a bit of attention as Skyrizi is one I haven't tried that has been recommended to me.  Lots of discussions I read and don't ask questions.

So I don't have a side so to speak, just questions. 

Yes... why.... and I also must guess here, but I think there are a number of reasons, also history concerned.
1. It is very cheap, there is no massive amount of money to be earned, except of course with MS and Tecfidera, which is way too expensive.
2. DMF is a NIH, product. A not invented here product, it was developed/discovered by a chemist in the backstreet of Germany, not by a dermatologist or research institute. I bet that for them this was really unimaginable that it could work.
3. Therefore only limited reseach is done in how it exactly works, yes we know that it reduces the cytokines, but that...hihi.. can basically be a side effect.
4. People are scared by the side effects: the flushes are weird, I know people who quite because of that, while they are perfectly harmless. The belly aches can be very serious and inconvenient. The real nasty side effect are the lymphocytes.
5. Because of e.g. Fumaderm, with the MEF in it, there was a danger for the kidneys, also serious.
6. Now there is Skilarence from Almirall, which is a colossal development mistake. While it already was known that Psorinovo for most people got rid of the belly aches because of its slow release, they developed Skilarence without slow release. an incredible stupidity as the belly aches are the most common reason that people stop with using DMF.
7. Almirall is a relatively small family company. They don’t the money for extensive research.
8. Biologicals are doing very well and people want quick results. Most patients don’t look deeper into the subject.
9. Biologicals are much more sexy than a 40-year old medication.

Well... perhaps there are a lot more reasons. E.g. in the rheumatology area with Psoriatic Arthritis they still always love to start with MTX... they also do not look any further as for them Psoriatic Arthritis is a kind of rheumatic arthritis.