Drug survival of fumaric acid esters for psoriasis

[Fred]

This is a retrospective, single-centre study assessing all patients commenced on FAEs between October 2003 and July 2012.

Quote:

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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.

Source: NO LINKS ALLOWED

[Caroline]

Interesting... But I know people that are at least for 10 years on DMF, on a dose that is much higher, even 20x 120 mg, without problems.

Discontinuation rate seems to be due to gastrointestinal causes, which makes it probably clear that slow release like Psorinovo makes a lot of sense.
I am 100% sure that Psorinovo users were not in this survey.


Interesting also are the conclusions of Bill on taking the medication.

[slm]

Thanks Fred for the new posts. I am gradually learning more about this disease. I am grateful for the information.

[jiml]

This is a retrospective, single-centre study assessing all patients commenced on FAEs between October 2003 and July 2012.

Quote:

---

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.

Source: NO LINKS ALLOWED

It also doesn't specify which FAE was it psorinovo or Fumaderm or another compound of the drug? As Caroline points out there is a big difference in the way they are released and thereby tolerated by patients

[Caroline]

This is a retrospective, single-centre study assessing all patients commenced on FAEs between October 2003 and July 2012.

Quote:

---

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.

Source: NO LINKS ALLOWED

It also doesn't specify which FAE was it psorinovo or Fumaderm or another compound of the drug?

I am quite sure that it certainly was not psorinovo.
My drugstore said today, that other patients use other versions of DMF, there seem to be more even besides Fumaderm.

[Fred]

Thanks Fred for the new posts. I am gradually learning more about this disease. I am grateful for the information.

You're welcome, it's good to know my information is helping you.

It also doesn't specify which FAE was it psorinovo or Fumaderm or another compound of the drug? As Caroline points out there is a big difference in the way they are released and thereby tolerated by patients

Jim it was Fumaric acid esters, so not a specific brand name see Caroline's comment.

I am quite sure that it certainly was not psorinovo.
My drugstore said today, that other patients use other versions of DMF, there seem to be more even besides Fumaderm.

Yes there are more than Psorinovo or Fumaderm, Bill is even using his own.

[jiml]

Which makes it a pretty useless study as there are differences it's like comparing cooking apples to desert apples, one is likely to upset your stomach the other isn't in my opinion

[Caroline]

Which makes it a pretty useless study as there are differences it's like comparing cooking apples to desert apples, one is likely to upset your stomach the other isn't in my opinion

Well exactly this stomach upsetting is clear. That happens with unprotected DMF. Bill is also always taking his measures to get it as fast as possible into the intestines.
I guess most of the different types have stomach protection or delayed release.

By the way, it is always the ester of fumaric acid that is used, we normally name it DMF, but it is in the ester form.

[Fred]

Which makes it a pretty useless study as there are differences it's like comparing cooking apples to desert apples, one is likely to upset your stomach the other isn't in my opinion

Opinions are good that's why I post this stuff on Psoriasis Club, I wish a few more would have an opinion and have their say.

[Caroline]

Which makes it a pretty useless study as there are differences it's like comparing cooking apples to desert apples, one is likely to upset your stomach the other isn't in my opinion

Opinions are good that's why I post this stuff on Psoriasis Club, I wish a few more would have an opinion and have their say.

To my opinion this study is quite less stupid than Sport could lower risk of psoriasis.....