Dimethylfumarates and Psoriasis

[Caroline]

Thirteen years later, in 1998 dr Kunst had more than 1500 patients with psoriasis treated with psorinovo. He published his experiences in an article in which he pointed to the above described research of Schweckendieck about generating artificial fever with fumarate (3 Kunst, L., Fumaarzuurtherapie bij psoriasis, Ned Tijdschr Int Geneeskd.1998; 6, 243-251). Dr Kunst concluded that a deficiency of fumaric acid or its inhibition results in an energy deficit, which apart from the onset of psoriasis, also can be expressed in reduced body temperature, fatigue, feel less energetic, etc.
These phenomena are, because they are so general, by physicians often overlooked and not associated with psoriasis. In his practice, dr Kunst has however at dozens of psoriasis patients not only determined their temperature (sometimes morning temperatures of 36.7 ° C and below), but also that the psoriasis began to improve only when the temperature was clearly increased. One example describes M.de Bruijn in his medical history on this website. Treated patients also regularly stated that they were going to feel more energetic as the psorinovotherapie went successful.
Based on the results of temperature measurements and the subjective experiences of patients, dr Kunst concluded that the beneficial effect of fumarate actually has something to do with improving the energy metabolism and the concerned citric acid cycle (fumaarzuurcyclus).
An observation that was necessary because in the apparent contradiction with this, the operation of fumarates, in general, is perceived as an inhibition of autoimmune symptoms. A one-sided view which has important implications for the application of the drug because drugs in this category generally have very undesirable side effects. However, whether the efficacy of fumarate in psoriasis patients is based on such stimulation of the citric acid cyle, in the present state of science this can be answered with certainty only by measuring the basal metabolism before and during the use of this drug. Such research is in the literature so far not yet described and, where dr Kunst is known, also nowhere suggested.