Section : Articles

Oral Fumaric Acid: how long is it tolerated ?

  • Fumaric acid esters (FAE) (oral intake) are used in come countries (Germany…) in the treatment of psoriasis.
  • It is an effective drug however its limitations lie in the fact that it can cause gastrointestinal symptoms as well as flushing
  • In this retrospective study from Ireland done in 249 patients, demographic data, length of treatment, reasons for discontinuation of FAEs, side-effects and range of doses were recorded.
  • The top three reasons for discontinuation were: lack of efficacy, gastrointestinal upset and lymphopaenia. Inolerable flushing only concerned 3% (n=5) of patients
  • This study shows that the FAEs can be continued for 4 years in 60% of patients (drug survival). This is compared with a 40% 4-year survival for adalimumab and etanercept and 70% for infliximab.
  • Moreover in patients on a low dose of FAE (less than 240mg per day), control could be achieved in 10% (N=26) of patients for a mean duration of more than 5 years (from 32 months to 106 months).


Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Article selection: Prof Dr Jean-Hilaire Saurat – dermatologist. Geneva, Switzerland

Source of information: Drug survival of fumaric acid esters for psoriasis: a retrospective study. Ismail N, Collins P, Rogers S, Kirby B, Lally A. Br J Dermatol. 2014 Aug;171(2):397-402. doi: 10.1111/bjd.12849. Epub 2014 Aug 6.