Department of Dermatology, Krankenhaus Hietzing, Vienna, Austria.
Division of Dermatology and Dermato-Oncology, Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2019 Oct;131(19-20):485-492. doi: 10.1007/s00508-019-01551-6. Epub 2019 Oct 7.
Fumaric acid esters are recommended in European guidelines for induction and maintenance treatment of patients with moderate to severe plaque psoriasis. A systemic medication with pure dimethyl fumarate without monoethyl fumarate salts was recently licensed in Europe.
The efficacy and safety of pure dimethyl fumarate were assessed in patients with severe (physician global assessment) plaque psoriasis in Austria in the BRIDGE trial.
In this double blind, randomized, placebo-controlled trial patients received 16-week treatment with pure dimethyl fumarate in a head to head comparison with dimethyl fumarate with monoethyl fumarate salts, which is licensed in Germany. In this post hoc analysis the efficacy and safety were assessed in patients with severe psoriasis in Austria.
Efficacy measures significantly improved in both active treatment arms compared to placebo in 65 patients after 16 weeks of treatment. Physician global assessment of clear/almost clear in the dimethyl fumarate group was non-inferior to the dimethyl fumarate with monoethyl fumarate salts group 2 months after end of treatment. No serious adverse reaction occurred in patients with dimethyl fumarate in contrast to the second active treatment. Efficacy outcome was paralleled by quality of life improvements.
This is the first report of dimethyl fumarate in a severely affected population with plaque psoriasis. Dimethyl fumarate is effective and safe in the systemic treatment of adults with severe psoriasis (physician global assessment).
富马酸酯类药物被欧洲指南推荐用于中重度斑块状银屑病患者的诱导和维持治疗。最近,一种不含单乙酯盐的纯二甲基富马酸制剂在欧洲获得了许可。
BRIDGE 试验在奥地利评估了纯二甲基富马酸在重度(医生整体评估)斑块状银屑病患者中的疗效和安全性。
在这项双盲、随机、安慰剂对照试验中,患者接受了 16 周的纯二甲基富马酸治疗,与在德国获得许可的含单乙酯盐的二甲基富马酸进行头对头比较。在此事后分析中,评估了在奥地利重度银屑病患者中的疗效和安全性。
在 65 名患者中,与安慰剂相比,在 16 周的治疗后,两种活性治疗组的疗效指标均显著改善。在治疗结束后 2 个月,二甲基富马酸组医生整体评估为清除/几乎清除,其非劣效于含单乙酯盐的二甲基富马酸组。与第二种活性治疗相比,在使用二甲基富马酸的患者中未发生严重不良反应。疗效结果与生活质量的改善相一致。
这是首例关于在重度斑块状银屑病患者中使用二甲基富马酸的报告。二甲基富马酸在成人重度银屑病(医生整体评估)的系统治疗中是有效且安全的。