Fumaric acid esters (FAE) monoethylfumarate “(MEF) and dimethyl (DMF) is derived from the base compound fumaric chemical compound. Fumaric acid is a common food additive in the candy and cake in the state of this chemical fumaric acid malabsorption, directly through the body does not have any impact other hand, fumarate chemicals or drugs has more than 30 years for the treatment of psoriasis. however, this is only in severe clinical studies have been conducted in the past decade, their use to determine the efficacy and safety of the treatment of psoriasis and other skin conditions.

It is important to emphasize the differences between the fumaric acid and fumaric acid esters. Fumaric acid preparations as health care products, often natural alternatives on the market, and the treatment of psoriasis drug. But in fact, it is very difficult to be absorbed intestinal basically excreted through urine, without having any therapeutic effect.

History
Use in the treatment of psoriasis fumarate for the first time in the late 1950s by the German chemist Schweckendiek. Development and use of standardized fumaric acid “agreement, the treatment of psoriasis FAE oral and topical (creams and bath gel). The results are promising, but there are serious side effects.

At that time, it was considered psoriasis of the citric acid cycle (Krebs) which fumarate play the important role in the biochemical defect caused. “Mode field applications engineers and their place is unclear role in psoriasis treatment, there is evidence that it did not do the main active compounds of the Krebs cycle seems fumaric acid dimethyl ester (DMF). This is considered to is by correcting psoriasis (transferred from the immune response of the Th1 cell mode to a Th2-) in the presence of immune imbalance.

User
Fumarate has been used to treat severe psoriasis for more than 20 years in the Nordic. However, applications engineers are still not registered in countries outside Germany, including the United Kingdom, the United States and New Zealand. Only authorized Fumaric acid esters is product Fumaderm? And is made of dimethyl ester and calcium, magnesium, and zinc salts of monoethyl hydrogen fumarate. Since 1994, the product has been approved for use in Germany. Others are seeking a licensed product, but so far, it is still not approved for the treatment of any disease, by FDA or Medsafe (New Zealand).

Many recent studies have shown that the application engineers who have tried and failed traditional psoriasis treatment of severe psoriasis patients is an effective treatment. Tolerate FAE treatment patients can expect a 75% improvement in their psoriasis within four months. In addition, application engineers are a combination of additional benefits, and the second line of drugs, such as cyclosporine, methotrexate, hydroxyurea or second line agents, in order to reduce the dose.

Side effect
Lead to high dropout rates in most clinical trials of major side effects is stomach upset occurs in as many as 60% of patients. Gastrointestinal problems, diarrhea, nausea, stomach cramps and pain. In addition, flushing occurs in 30% of patients, and worse in the disease treatment.

Other more serious side effects, including renal dysfunction and reduction of abnormal function and white blood cells. Importantly, renal function and blood counts should be monitored regularly, Field Application Engineer. These changes seem to be reversible when the treatment is stopped, so far no to report serious long-term toxicity.

Further research is needed to determine exactly how the application engineers work of psoriasis. The dimethyl fumarate main active ingredient and refined the FAE recipe currently available can reduce the side effects, and making it easier to accept the further investigation of the treatment of psoriasis.