Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Br J Dermatol. 2013 Jun;168(6):1343-7. doi: 10.1111/bjd.12231.
Fumaric acid esters (FAE) are used as an effective and safe oral treatment for plaque psoriasis in adult patients, but little is known about their efficacy and safety in children with psoriasis.
To assess the effectiveness and safety of FAE in the treatment of paediatric psoriasis.
This is a retrospective analysis of 14 paediatric patients with psoriasis (age <18 years) treated with FAE between 2004 and 2012 at several Dutch university and regional clinics. Patients were identified through databases or registries.
The median age at the start of FAE treatment was 15 years (range 8-17 years). The median duration of FAE treatment was 10 months (range 1-80 months), and the median maintenance dosage per day was 360 mg dimethylfumarate (range 240-600 mg). Five patients (36%) achieved a complete clearance of their psoriasis, one patient (7%) had a good improvement, three patients (21%) had a partial response and five patients (36%) were nonresponders. FAE treatment was well tolerated, but two patients (14%) discontinued FAE, one with severe diarrhoea and one with flushes. Five patients (36%) had transient, slightly abnormal laboratory values of liver-function tests or leucocytes that did not necessitate FAE dosage reduction or treatment discontinuation. No serious adverse events occurred.
In this retrospective case series FAE seemed to be an effective and safe treatment for children with psoriasis. FAE may be an attractive therapeutic alternative to the currently used systemic immunosuppressive agents for paediatric patients with psoriasis. Further studies are needed to evaluate the suitability of FAE in paediatric psoriasis.
富马酸酯（FAE）被用作治疗成人斑块状银屑病的有效且安全的口服药物，但对于儿童银屑病患者，其疗效和安全性知之甚少。
评估 FAE 治疗儿童银屑病的疗效和安全性。
这是一项回顾性分析，纳入了 2004 年至 2012 年期间在荷兰几所大学和地区诊所接受 FAE 治疗的 14 例银屑病儿童患者（年龄<18 岁）。通过数据库或登记册识别患者。
FAE 治疗开始时的中位年龄为 15 岁（范围 8-17 岁）。FAE 治疗的中位持续时间为 10 个月（范围 1-80 个月），每天的维持剂量中位数为 360mg 二甲基富马酸酯（范围 240-600mg）。5 例患者（36%）的银屑病完全清除，1 例患者（7%）有良好改善，3 例患者（21%）有部分反应，5 例患者（36%）无反应。FAE 治疗耐受性良好，但有 2 例患者（14%）停药，1 例因严重腹泻，1 例因潮红。5 例患者（36%）出现短暂的、轻度异常的肝功能或白细胞实验室值，无需减少 FAE 剂量或停药。未发生严重不良事件。
在本回顾性病例系列研究中，FAE 似乎是治疗儿童银屑病的一种有效且安全的治疗方法。FAE 可能是目前用于治疗儿童银屑病的免疫抑制药物的一种有吸引力的治疗选择。需要进一步研究来评估 FAE 在儿童银屑病中的适用性。
