[split] Dimethylfumarates and Psoriasis

[jiml]

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 )

[Fred]

(could give you the link of course, but that is against policy you can find it yourself).

But it's still taking people away.

[Caroline]

(could give you the link of course, but that is against policy you can find it yourself).

But it's still taking people away.  

Yes, which is stupid. Because not allowing links makes the site extremely safe.

[Bill]

Thanks for the links, Caroline. I have noticed feeling very dehydrated after taking DMF, so having it with plenty of fluids may mitigate headaches and protect the kidneys. It was also interesting to read that DMF inhibits dendrocyte maturation. The absence of mature dendrocytes may be why new spots disappear quickly. As for the treatment guidlines, I feel that they greatly limit the potential benefit of DMF. If I had followed them I might not have got below 5-10% coverage, although this point is moot as I would have had to cease taking the drug due to severe lymphopaenia.

Cheers,

Bill

[Caroline]

Thanks for the links, Caroline. I have noticed feeling very dehydrated after taking DMF, so having it with plenty of fluids may mitigate headaches and protect the kidneys. It was also interesting to read that DMF inhibits dendrocyte maturation. The absence of mature dendrocytes may be why new spots disappear quickly. As for the treatment guidlines, I feel that they greatly limit the potential benefit of DMF. If I had followed them I might not have got below 5-10% coverage, although this point is moot as I would have had to cease taking the drug due to severe lymphopaenia.

Cheers,

Bill

Gladly done Bill, I may come up with more if I bump into something interesting.

About the treatment guidelines, what do you exactly mean.
My guess is that you mean that the intermittent way you take DMF protects your mainly from lumphopaenia, is that a correct observation?
You observation may learn us much on the dealing with DMF.

Cheers,
Caroline

[Bill]

3*240 mg stopped reducing my psoriasis coverage within six months and may have knocked down my lymphocyte count too far. With  my current dose (800 mg every five days, and I am about to drop back to weekly doses) the disease is almost gone and the lymphocyte count is in safe territory. With the benefit of hindsight I would have started on 360 mg single doses every other day, taken with plenty of food and fluids. Otherwise I would have followed the same principles as the guidelines except that I would stick with the largest dosage but increase the interval between doses as the disease improved.

Cheers,

Bill

[Bill]

And one point in the therapeutic guidelines is that DMF alone was compared with DMF and MEF in a clinical study and was found to be less effective. So even though no benefit can be found in the lab, this is not to say that MEF is not beneficial.

Cheers,

Bill

[Caroline]

And one point in the therapeutic guidelines is that DMF alone was compared with DMF and MEF in a clinical study and was found to be less effective. So even though no benefit can be found in the lab, this is not to say that MEF is not beneficial.

Cheers,

Bill

Indeed Bill, that is correct. The combination of DMF and MEF, like in Fumaderm, is found to be a bit more effective.
Doctor Kunst (I have personally spoken with him some time ago but perhaps more on that another time) has done extensive research while developing Psorinovo in combination with the pharmacologist who was going to produce it.
They started with the initial configuration of 8 chemicals in the compound, which was known in Germany. While researching they found that none of the chemicals except for two DMF and MEF did something for (against) psoriasis. But, it seemed that the positive effect of MEF was more due to the availability of a metal-ion in it, this while MEF was proven toxic for the kidneys. So what they therefore did to improve the effectiveness of Psorinovo and make it as effective as the combination, was the addition of a copper-ion to DMF. The advantage of this was additional better performance in regard to the lymphocytes.
Currently Psorinovo does not contain this ion anymore, the reason of which I do not know exactly only that I know that they were forced to remove it by some organization.
As the increase in effectiveness is only limited, they stayed with pure DMF.
It is amazing when you realize that they did this about 25 years ago

Cheers,
Caroline

[Bill]

Thanks for the clarification, Caroline. It is very complicated.

[jiml]

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