Dimethyl fumarate titration for the systemic treatment of moderate-to-severe plaque psoriasis

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Abstract

Background: Dimethyl fumarate (DMF) is an oral systemic agent approved for the treatment of moderate-to-severe psoriasis vulgaris. It has a favourable tolerability profile, but it is associated with a high incidence of mild and reversible adverse events. The aim of the article is to describe a clinical experience aimed at increasing tolerability.

Patients and methods: A group of patients was treated with DMF with a titration schedule, according to clinical practice, although a personalization of the step-up timing was allowed. The highest dose was the minimal effective dose or the maximal tolerated doses.

Results: DMF treatment was effective in reducing the disease severity and improving the quality of life. DMF was well tolerated as only mild, mainly gastrointestinal, adverse events occurred in these patients. In addition, the up-titration schedule seemed to provide a reduced incidence of adverse events compared with the fixed dose.

Conclusion: Our experience suggested that the recommended up-titration schedule of DMF, adjusted and personalized according to patient needs and physician opinion, provided a relevant clinical benefit and was well tolerated.

Keywords: dimethyl fumarate, plaque psoriasis, systemic conventional treatment.

Citation: Malara G, Fabbrocini G, Trifirò C, Burlando M. Dimethyl fumarate titration for the systemic treatment of moderate-to-severe plaque psoriasis. Drugs in Context 2021; 10: 2020-12-4. DOI: 10.7573/dic.2020-12-4

Contributions: All authors contributed equally to the preparation of this article. All named authors identified and treated patients and analysed data. They all meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published. Editorial assistance was provided for this article, and all authors revised and approved the final manuscript.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/05/dic.2020-12-4-COI.pdf

Acknowledgements: Editorial assistance was provided by Laura Brogelli, MD, and Aashni Shah, of Polistudium srl (Milan, Italy). This activity was supported by Almirall. The supporting company was not offered the opportunity to revise the paper and had no role in the decision to submit.

Funding declaration: The study received an unconditioned grant from Almirall.

Copyright: Copyright © 2021 Malara G, Fabbrocini G, Trifirò C, Burlando M. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Malara G, Fabbrocini G, Trifirò C, Burlando M. https://doi.org/10.7573/dic.2020-12-4. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/dimethyl-fumarate-titration-for-the-systemic-treatment-of-moderate-to-severe-plaque-psoriasis

Correspondence: Giovanna Malara, Grande Ospedale Metropolitano, Via G Melacrino, Reggio Calabria, Italy. Email: giovannamalara@tiscali.it

Provenance: Submitted; externally peer reviewed.

Submitted: 14 December 2020; Accepted: 15 April 2021; Publication date: 31 May 2021.

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