Use of Oral Fumaric Acid Esters in Treatment of Dermatology Cases
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Published:
Aug 22, 2020
Keywords:
Dermatology, fumaric acid, psoriasis, sarcoidosis
Main Article Content
Abstract
Introduction: Oral fumaric esters acid (FAE) are interesting compounds in the field of dermatology. FAE works on skin cells and cytokine tissue. So far only a mixture of dimethylfumarate (DMF) and monoethylfumarate (MEF) has been approved for oral treatment of moderate to severe plaque psoriasis.
Objective: To determine the use of oral fumaric acid esters (FAE) in the treatment of dermatology
Method: The article was prepared using the literature review method, involving 34 literature sourced from books and journals.
Results: DMF appears to be a major active component. It is important to emphasize the difference between fumaric acid and fumaric acid esters. Fumaric acid formulations are available as health supplements and are often marketed as natural alternative medicines for treating psoriasis. However, it is poorly absorbed by the intestine and excreted through urine without having any therapeutic effect.
Discussion: Although the mode of action of FAE and its mechanism of action in psoriasis therapy is still unclear, the evidence shows that it has nothing to do with the Krebs cycle and the main active compound DMF. There is evidence that FAE is not only effective and safe in psoriasis but also non-granulomatous infectious diseases like annulare granulomas, necrobiosis lipoidica, and sarcoidosis. In vitro and animal studies show some activity in malignant melanoma as well.
Conclusion: Oral fumaric acid (FAE) esters are widely used in some dermatology cases.
Keywords: Dermatology, fumaric acid, psoriasis, sarcoidosis
Article Details
How to Cite
Rahma, E., & Anggraini, D. (2020). Use of Oral Fumaric Acid Esters in Treatment of Dermatology Cases. JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia, 8(2), 50-59. https://doi.org/10.53366/jimki.v8i2.138
Section
Article Review
References
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2. Balak DM. Fumaric acid esters in the management of psoriasis. Psoriasis Targets Ther. 2015;5:9–23.
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9. Emre S. Review of the use of fumaric acid esters in dermatology. J Turk Acad Dermatol. 2016;10(4):16104r1.
10. Yamauchi PS. Biologic and Systemic Agents in Dermatology. Los Angeles: Springer International Publishing; 2018. 199–208 p.
11. Ruggieri S, Tortorella C, Gasperini C. Pharmacology and clinical efficacy of dimethyl fumarate (BG-12) for treatment of relapsing-remitting multiple sclerosis. Ther Clin Risk Manag. 2014;10(1):229–38.
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14. McCormick T, Ayala-Fontanez N, Soler D. Current knowledge on psoriasis and autoimmune diseases. Psoriasis Targets Ther. 2016;6:7–32.
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16. Albanesi C, Madonna S, Gisondi P, Girolomoni G. The interplay between keratinocytes and immune cells in the pathogenesis of psoriasis. Front Immunol. 2018;9(1549):1–7.
17. Harjunpää H, Asens ML, Guenther C, Fagerholm SC. Cell adhesion molecules and their roles and regulation in the immune and tumor microenvironment. Front Immunol. 2019;10(1078):1–24.
18. Meissner M, Doll M, Hrgovic I, Reichenbach G, König V, Hailemariam-Jahn T, et al. Suppression of VEGFR2 expression in human endothelial cells by dimethylfumarate treatment: Evidence for anti-angiogenic action. J Invest Dermatol. 2011;131(6):1356–64.
19. Liu T, Zhang L, Joo D, Sun SC. NF-κB signaling in inflammation. Signal Transduct Target Ther. 2017;2(March):e17023.
20. Geisel J, Bruck J, Glocova I. Sulforaphane protects from T cell-mediated autoimmune disease by inhibition of IL-23 and IL-12 in dendritic cells. J Immunol. 2014;192:3530–9.
21. Wang Q, Chuikov S, Taitano S, Wu Q, Rastogi A, Tuck SJ, et al. Dimethyl fumarate protects neural stem/progenitor cells and neurons from oxidative damage through Nrf2-ERK1/2 MAPK pathway. Int J Mol Sci. 2015;16(6):13885–907.
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24. Atwan A, Ingram JR, Abbott R, Kelson MJ, Pickles T, Bauer A, et al. Oral fumaric acid esters for psoriasis: abridged Cochrane systematic review including GRADE assessments. Br J Dermatol. 2016;175(5):873–81.
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26. Lukács J, Schliemann S, Elsner P. Treatment of generalized granuloma annulare – a systematic review. J Eur Acad Dermatology Venereol. 2015;29(8):1467–80.
27. Zouboulis CC, Lippert U, Karagiannidis I. Multi-organ sarcoidosis treatment with fumaric acid esters: A case report and review of the literature. Dermatology. 2014;228(3):202–6.
28. Peckruhn M, Tittelbach J, Elsner P. Update: Therapie der Necrobiosis lipoidica. JDDG - J Ger Soc Dermatology. 2017;15(2):151–7.
29. Kuhn A, Landmann A, Patsinakidis N, Ruland V, Nozinic S. Fumaric acid ester treatment in cutaneous lupus erythematosus (CLE): a prospective, open-label, phase II pilot study. Lupus. 2016;25:1357–64.
30. Blake SC, Daniel BS. Cutaneous lupus erythematosus: A review of the literature. Int J Women’s Dermatology. 2019;5(5):320–9.
31. Niculescu L, Heppt M V, Varga R, Steckmeier S, Wolff H, Tietze JK. Retrospective analysis of the application of fumaric acid esters in 13 patients with alopecia areata. Eur J Dermatology. 2018 May 1;28(3):376–7.
32. Kang KY, Hwang YH, Lee SJ, Jang HY, Hong SG, Mun SK, et al. Verification of the Functional Antioxidant Activity and Antimelanogenic Properties of Extracts of Poria cocos Mycelium Fermented with Freeze-Dried Plum Powder. Int J Biomater. 2019;2019:1–8.
33. Dickel H, Bruckner T, Altmeyer P. Long-term real-life safety profile and effectiveness of fumaric acid esters in psoriasis patients: a single-centre, retrospective, observational study. J Eur Acad Dermatology Venereol. 2018;32(10):1710–27.
34. Menter A, Gelfand JM, Connor C, Armstrong AW, Cordoro KM, Davis DMR, et al. Guidelines Of Care For The Management Of Psoriasis With Systemic Non-Biological Therapies. J Am Acad Dermatol. 2020;1:1–93.
2. Balak DM. Fumaric acid esters in the management of psoriasis. Psoriasis Targets Ther. 2015;5:9–23.
3. Landeck L, Asadullah K, Amasuno A, Pau-Charles I, Mrowietz U. Dimethyl fumarate (DMF) vs. monoethyl fumarate (MEF) salts for the treatment of plaque psoriasis: a review of clinical data. Arch Dermatol Res. 2018;310(6):475–83.
4. Gibson T, Lambert C, Dinges J. Fumaric acid esters. In: Bioactive carboxylic compound classes: pharmaceuticals and agrochemicals. first ed. KGaA Weinheim: Wiley-VCH Verlag GmbH & Co; 2016. p. 209–19.
5. Mrowietz U, Barker J, Boehncke WH, Iversen L, Kirby B, Naldi L, et al. Clinical use of dimethyl fumarate in moderate-to-severe plaque-type psoriasis: a European expert consensus. J Eur Acad Dermatology Venereol. 2018;32(Suppl. 3):3–14.
6. Boehncke W-H, Schon MP. Psoriasis. Lancet. 2015 Sep;386(9997):983–94.
7. Schmitt A, Volz A. Non-infectious granulomatous dermatoses. J der Dtsch Dermatologischen Gesellschaft. 2019 May;17(5):518–33.
8. Brück J, Dringen R, Amasuno A, Pau-Charles I, Ghoreschi K. A review of the mechanisms of action of dimethylfumarate in the treatment of psoriasis. Exp Dermatol. 2018;27(6):611–24.
9. Emre S. Review of the use of fumaric acid esters in dermatology. J Turk Acad Dermatol. 2016;10(4):16104r1.
10. Yamauchi PS. Biologic and Systemic Agents in Dermatology. Los Angeles: Springer International Publishing; 2018. 199–208 p.
11. Ruggieri S, Tortorella C, Gasperini C. Pharmacology and clinical efficacy of dimethyl fumarate (BG-12) for treatment of relapsing-remitting multiple sclerosis. Ther Clin Risk Manag. 2014;10(1):229–38.
12. Deng Y, Chang C, Lu Q. The inflammatory response in psoriasis: a comprehensive review. Clin Rev Allergy Immunol. 2016;50:377–89.
13. Diani M, Altomare G, Reali E. Helper cell subsets in clinical manifestations of psoriasis. J Immunol Res. 2016;1(1):1–7.
14. McCormick T, Ayala-Fontanez N, Soler D. Current knowledge on psoriasis and autoimmune diseases. Psoriasis Targets Ther. 2016;6:7–32.
15. Boehncke W-H, Schön M. Psoriasis. Lancet. 2015;386:983–94.
16. Albanesi C, Madonna S, Gisondi P, Girolomoni G. The interplay between keratinocytes and immune cells in the pathogenesis of psoriasis. Front Immunol. 2018;9(1549):1–7.
17. Harjunpää H, Asens ML, Guenther C, Fagerholm SC. Cell adhesion molecules and their roles and regulation in the immune and tumor microenvironment. Front Immunol. 2019;10(1078):1–24.
18. Meissner M, Doll M, Hrgovic I, Reichenbach G, König V, Hailemariam-Jahn T, et al. Suppression of VEGFR2 expression in human endothelial cells by dimethylfumarate treatment: Evidence for anti-angiogenic action. J Invest Dermatol. 2011;131(6):1356–64.
19. Liu T, Zhang L, Joo D, Sun SC. NF-κB signaling in inflammation. Signal Transduct Target Ther. 2017;2(March):e17023.
20. Geisel J, Bruck J, Glocova I. Sulforaphane protects from T cell-mediated autoimmune disease by inhibition of IL-23 and IL-12 in dendritic cells. J Immunol. 2014;192:3530–9.
21. Wang Q, Chuikov S, Taitano S, Wu Q, Rastogi A, Tuck SJ, et al. Dimethyl fumarate protects neural stem/progenitor cells and neurons from oxidative damage through Nrf2-ERK1/2 MAPK pathway. Int J Mol Sci. 2015;16(6):13885–907.
22. Steinz K, Gerdes S, Domm S, Mrowietz U. Systemic treatment with fumaric acid esters in six paediatric patients with psoriasis in a psoriasis centre. Dermatol. 2014;229:199–204.
23. Reszke R, Szepietowski JC. A safety evaluation of dimethyl fumarate in moderate-to-severe psoriasis. Expert Opin Drug Saf. 2020 Mar 4;1:1–8.
24. Atwan A, Ingram JR, Abbott R, Kelson MJ, Pickles T, Bauer A, et al. Oral fumaric acid esters for psoriasis: abridged Cochrane systematic review including GRADE assessments. Br J Dermatol. 2016;175(5):873–81.
25. Weisenseel P, Reich K, Griemberg W, Merten K. Efficacy and safety of fumaric acid esters in combination with phototherapy in patients with moderate‐to‐severe plaque psoriasis (FAST). JDDG J der Dtsch Dermatologischen Gesellschaft. 2017;15:180–6.
26. Lukács J, Schliemann S, Elsner P. Treatment of generalized granuloma annulare – a systematic review. J Eur Acad Dermatology Venereol. 2015;29(8):1467–80.
27. Zouboulis CC, Lippert U, Karagiannidis I. Multi-organ sarcoidosis treatment with fumaric acid esters: A case report and review of the literature. Dermatology. 2014;228(3):202–6.
28. Peckruhn M, Tittelbach J, Elsner P. Update: Therapie der Necrobiosis lipoidica. JDDG - J Ger Soc Dermatology. 2017;15(2):151–7.
29. Kuhn A, Landmann A, Patsinakidis N, Ruland V, Nozinic S. Fumaric acid ester treatment in cutaneous lupus erythematosus (CLE): a prospective, open-label, phase II pilot study. Lupus. 2016;25:1357–64.
30. Blake SC, Daniel BS. Cutaneous lupus erythematosus: A review of the literature. Int J Women’s Dermatology. 2019;5(5):320–9.
31. Niculescu L, Heppt M V, Varga R, Steckmeier S, Wolff H, Tietze JK. Retrospective analysis of the application of fumaric acid esters in 13 patients with alopecia areata. Eur J Dermatology. 2018 May 1;28(3):376–7.
32. Kang KY, Hwang YH, Lee SJ, Jang HY, Hong SG, Mun SK, et al. Verification of the Functional Antioxidant Activity and Antimelanogenic Properties of Extracts of Poria cocos Mycelium Fermented with Freeze-Dried Plum Powder. Int J Biomater. 2019;2019:1–8.
33. Dickel H, Bruckner T, Altmeyer P. Long-term real-life safety profile and effectiveness of fumaric acid esters in psoriasis patients: a single-centre, retrospective, observational study. J Eur Acad Dermatology Venereol. 2018;32(10):1710–27.
34. Menter A, Gelfand JM, Connor C, Armstrong AW, Cordoro KM, Davis DMR, et al. Guidelines Of Care For The Management Of Psoriasis With Systemic Non-Biological Therapies. J Am Acad Dermatol. 2020;1:1–93.