[split] Dimethylfumarates and Psoriasis

[Fred]

That reminds me I don't know if it is of interest to the DMF gang but I asked my dermatologist how the trial on Fumaderm went at my hospital in France.

It has been dropped and will not be made available under the French health care system.. She didn't say exactly why, but it seems by what I could work out it was dropped in favour of accepting Otezla and Cosentyx.

[jiml]

That reminds me I don't know if it is of interest to the DMF gang but I asked my dermatologist how the trial on Fumaderm went at my hospital in France.

It has been dropped and will not be made available under the French health care system.. She didn't say exactly why, but it seems by what I could work out it was dropped in favour of accepting Otezla and Cosentyx.

How strange on price alone I would think fumaderm would be a good choice it's far cheaper than either of the other two otezla and cosentyx
I'm sure there are other reasons because it's far less harmful than methotrexate and in my opinion safer than biological drugs

[Fred]

That reminds me I don't know if it is of interest to the DMF gang but I asked my dermatologist how the trial on Fumaderm went at my hospital in France.

It has been dropped and will not be made available under the French health care system.. She didn't say exactly why, but it seems by what I could work out it was dropped in favour of accepting Otezla and Cosentyx.

How strange on price alone I would think fumaderm would be a good choice it's far cheaper than either of the other two otezla and cosentyx
I'm sure there are other reasons because it's far less harmful than methotrexate and in my opinion safer than biological drugs

I couldn't get any more from her Jim. My knowledge of the French system is that they don't tend to judge by cost as they have a very healthy budget, so I'm guessing it must have been the results from their own tests that gave them their decision. They maybe look at clearance times or how many people drop out of a test. You guess is as good as mine. It could be they can only bring in so many new treatments per year I don't know, but she gave me the impression it will never be available in France.

I suppose it's better than the way the UK are doing it. As you know some can get it but other parts of the country have no chance, is that the way the UK test it?

[jiml]

That reminds me I don't know if it is of interest to the DMF gang but I asked my dermatologist how the trial on Fumaderm went at my hospital in France.

It has been dropped and will not be made available under the French health care system.. She didn't say exactly why, but it seems by what I could work out it was dropped in favour of accepting Otezla and Cosentyx.

How strange on price alone I would think fumaderm would be a good choice it's far cheaper than either of the other two otezla and cosentyx
I'm sure there are other reasons because it's far less harmful than methotrexate and in my opinion safer than biological drugs

I couldn't get any more from her Jim. My knowledge of the French system is that they don't tend to judge by cost as they have a very healthy budget, so I'm guessing it must have been the results from their own tests that gave them their decision. They maybe look at clearance times or how many people drop out of a test. You guess is as good as mine. It could be they can only bring in so many new treatments per year I don't know, but she gave me the impression it will never be available in France.

I suppose it's better than the way the UK are doing it. As you know some can get it but other parts of the country have no chance, is that the way the UK test it?

Here I think it's up to the individual dermatologist I think.. To put a case to the head of dermatology and I think rather than make waves they just go with the flow.
I will try to find more out next Friday when I am at the teaching hospital (as a patient) not a doctor but I can have a word with the consultants there and see what their thinking is

[Fred]

Here I think it's up to the individual dermatologist I think.. To put a case to the head of dermatology and I think rather than make waves they just go with the flow.
I will try to find more out next Friday when I am at the teaching hospital (as a patient) not a doctor but I can have a word with the consultants there and see what their thinking is

It will be interesting to find out if it is a test being done in parts of the UK.

I thought it was a postcode lottery and down to local funding, but it got me thinking it could be a way of testing it.

Let me know if you do find anything, I won't hijack the DMF thread.

[jiml]

Here I think it's up to the individual dermatologist I think.. To put a case to the head of dermatology and I think rather than make waves they just go with the flow.
I will try to find more out next Friday when I am at the teaching hospital (as a patient) not a doctor but I can have a word with the consultants there and see what their thinking is

It will be interesting to find out if it is a test being done in parts of the UK.

I thought it was a postcode lottery and down to local funding, but it got me thinking it could be a way of testing it.

Let me know if you do find anything, I won't hijack the DMF thread.

I don't think it's a test I've been on it for four years now and haven't had a serious conversation about it in that time
I'm well monitored and then left to my own devices

[Caroline]

AAANDDD Another one    

(It's quiet at the office, so take part of the lunchtime to do some searching... )

British Journal of Dermatology 1999; 141: 424±429.
Treatment of severe psoriasis with fumaric acid esters: scientifc background and guidelines for therapeutic use

This is a nice PDF file with a complete description (could give you the link of course, but that is against policy you can find it yourself). Interestingly the use of DMF is even older than I thought. The publication is 1999 and they are already talking about 30 years of DMF use. That means that seen from our point in time, it's a 45 year old therapy.  

Will look that one up in my lunch time when my office is quiet ( i.e. When the Ironing is finished )

Just finished reading and can't say I understand it all but was interested to read that the combination therapy i.e Fumaderm was more effective than DMF alone (page426)
Also that it is effective against psoriatic arthritis ( although in the uk not prescribed for that) and we already know that fact
Overall it was a good read but to be honest a bit over my head

That is correct that it is more effective, But that is due to some ion somewhere, that is safer to add via a copper ion, than the addition of MMF, which last is toxic for the kidneys, therefore also the limitation to max 6x120

In the beginning Psorinovo had the copper ion added, but because of some stupid written rule this was gotten out again. So now it's only DMF, just as what Bill is having, only slow release.

[Caroline]

Here I think it's up to the individual dermatologist I think.. To put a case to the head of dermatology and I think rather than make waves they just go with the flow.
I will try to find more out next Friday when I am at the teaching hospital (as a patient) not a doctor but I can have a word with the consultants there and see what their thinking is

It will be interesting to find out if it is a test being done in parts of the UK.

I thought it was a postcode lottery and down to local funding, but it got me thinking it could be a way of testing it.

Let me know if you do find anything, I won't hijack the DMF thread.

It is awkward that they may be dropping it, while on the other hand it now finally seems in the Netherlands that DMF may be the first treatment to have a start with, if you are having serious psoriasis.

[Bill]

It would be interesting to know the reasons. On a cost/benefit basis it surely would compete with other systemics. I am now on 810 mg weekly and have a total coverage of about half a dozen fingerprints of inactive and reducing disease.

[Caroline]

Despite the existing gentlemens agreement, tec-fi-de-ra (written like this to prevent it to be picked up by bots) is now registered for psoriasis in the Netherlands.
Spoken to some people on a meeting of the *Removed by Fred, and the main opinion is that B-Phama is absolutely untrustworthy. Unfortunately we have to deal with that. Luckily there is a trend that patients communities are being encouraged and get more power in our country. From there politics will have to be provided with information on which they can act in our name.