[split] Dimethylfumarates and Psoriasis

[Caroline]

Continued from RE: Cosentyx - Week 1....and beyond...., as we were stealing Angels thread.  

You dont pick your drug like you pick the flavours of gelati or milkshakes, nor do you necessarily get your drug of choice. In this instance the insurance company is rescinding access to a very effective drug because of its cost. Cost is a major factor, which is why drugs like methotrexate are still used. The reason you dont see regimes like the one I suggested is because the treatment protocol involves treating patients with the cheapest drugs available. By the time you go on Enbrel and its ilk you dont have other options. Sadly you dont have access to DMF in the US for treating p. Why? Because it doesn't work? It leaves mtx for dead in terms of efficacy and safety and could be saving the health system a substantial amount.

Cheers,

Bill

Very true Bill. We all are very dependent on our doctors, GP's and dermatologists. And they again are tied to protocols that were made together with the insurances.
There are other reasons why the US does not give access to DMF. They are hidden in all kinds of regulations AND influences of Pharma.
I mean, of course it also works on that side of the ocean.
It would be a change to have "the" aspirin for psoriasis and PsA, but then no one can earn money on it. It would be extremely cheap, and personally I think that is the problem.

cheers,
Caroline

[Bill]

The hurdle for Biogen is that DMF is a mass produced industrial chemical that happens to be a very useful pharmaceutical. And the claim about it needing to be specially formulated is nonsense. I think it would be more effective were it mixed with toffee. It might even sell better.

[Caroline]

The hurdle for Biogen is that DMF is a mass produced industrial chemical that happens to be a very useful pharmaceutical. And the claim about it needing to be specially formulated is nonsense. I think it would be more effective were it mixed with toffee. It might even sell better.

Again we agree greatly  !!!!

the big problem is, how do we influence the current situation.

[mataribot]

Continued from RE: Cosentyx - Week 1....and beyond...., as we were stealing Angels thread.

[quote='Bill' pid='65419' dateline='1449658312']
You dont pick your drug like you pick the flavours of gelati or milkshakes, nor do you necessarily get your drug of choice. In this instance the insurance company is rescinding access to a very effective drug because of its cost. Cost is a major factor, which is why drugs like methotrexate are still used. The reason you dont see regimes like the one I suggested is because the treatment protocol involves treating patients with the cheapest drugs available. By the time you go on Enbrel and its ilk you dont have other options. Sadly you dont have access to DMF in the US for treating p. Why? Because it doesn't work? It leaves mtx for dead in terms of efficacy and safety and could be saving the health system a substantial amount.

Cheers,

Bill

Over here in the USA you do as long as have decent employee based insurance. Forcing people to take medication they don't want to take will work as well as the prohibition. People simply will not take it. With this disease they'll end up costing more than any biologic. Just ask my dad about that one, he's already had 500,000 USD in surgery this year alone.

[Bill]

You take a drug on the recommendation of a specialist. If a specialist's recommendation was that you could have a more effective treatment at less than 1000th the cost, I wonder how keen the insurer would be to uphold the right of choice for the consumer? Insurance is a business, not a money pit.

[mataribot]

My insurance had no real choice with the Cosentyx. As the long your insurance covers it, the only choices they have are to price you out, or find a medical reason (side effect) that you can't take it.

[Caroline]

By the way, if you can read it, it is highly technical (I skipped most of it ) but it shows that the MEF in combination with DMF makes no sense. The article shows that it is even toxic.
Strange is that despite this was already known in 1989 !!, they still keep on using MEF in certain medications

search for the article by searching for: Hohenegger M., et al. Nephrotoxicity of Fumaric Acid Monoethylester (FA ME): Advances in Experimental Medicine and Biology, US 1989, vol 252, P 265-72.

Must be a piece of cake for Bill to read it.

[jiml]

By the way, if you can read it, it is highly technical (I skipped most of it ) but it shows that the MEF in combination with DMF makes no sense. The article shows that it is even toxic.
Strange is that despite this was already known in 1989 !!, they still keep on using MEF in certain medications

search for the article by searching for: Hohenegger M., et al. Nephrotoxicity of Fumaric Acid Monoethylester (FA ME): Advances in Experimental Medicine and Biology, US 1989, vol 252, P 265-72.

Must be a piece of cake for Bill to read it.  

I will wait and see his reaction

[Caroline]

And another interesting one:

Dimethyl fumarate modulation of immune and antioxidant responses: application to HIV therapy.

It seems that DMF is also active against HIV. Studie of 2013.
In this article they also talk about Fumaderm and Tecfidera.

[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.