{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:34:58Z","timestamp":1790080498129,"version":"4.0.1"},"reference-count":78,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T00:00:00Z","timestamp":1537401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Almirall S.A."}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Fumaric acid esters (<jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content>s) are a group of small molecules that were first investigated for the treatment of psoriasis in 1959. The first fumarate\u2010based drug \u2013 Fumaderm<jats:sup>\u00ae<\/jats:sup> \u2013 was approved in Germany in 1994 for severe psoriasis and then in 2008, the label was expanded to include moderate psoriasis. Fumaderm is a combination of different <jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content>s: dimethyl fumarate (<jats:styled-content style=\"fixed-case\">DMF<\/jats:styled-content>), which is regarded as the main active component, plus calcium, magnesium and zinc salts of monoethyl fumarate (<jats:styled-content style=\"fixed-case\">MEF<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content>s are the most frequently used first\u2010line systemic psoriasis treatment in Germany, with an overall treatment experience comprising more than 220\u00a0000 patient\u2010years. <jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content>s have demonstrated good, sustained clinical efficacy with an acceptable safety profile for the long\u2010term treatment of patients with moderate\u2010to\u2010severe psoriasis. Indeed, the European S3\u2010Guideline on the systemic treatment of <jats:italic>Psoriasis vulgaris<\/jats:italic> recommends <jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content>s for induction and long\u2010term treatment. Until recently, <jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content>s were only licensed (for the psoriasis indication) in Germany, but were imported to many other European countries, such as The Netherlands, <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>, Ireland, Austria and Italy, for the treatment of psoriasis. In 2017, the European Medicines Agency (<jats:styled-content style=\"fixed-case\">EMA<\/jats:styled-content>) approved Skilarence<jats:sup>\u00ae<\/jats:sup>, a new oral formulation of <jats:styled-content style=\"fixed-case\">DMF<\/jats:styled-content>, for the treatment of adult patients with moderate\u2010to\u2010severe chronic plaque psoriasis in need of systemic therapy. Skilarence only contains <jats:styled-content style=\"fixed-case\">DMF<\/jats:styled-content> and is the first <jats:styled-content style=\"fixed-case\">FAE<\/jats:styled-content> for the treatment of psoriasis that has been approved by the <jats:styled-content style=\"fixed-case\">EMA<\/jats:styled-content>. This approval has given rise to a new oral treatment option for patients with moderate\u2010to\u2010severe plaque psoriasis across Europe. Here, we report the results of an expert meeting which was convened to deliver clinician\u2010agreed consensus and real\u2010world guidance on the clinical use of <jats:styled-content style=\"fixed-case\">DMF<\/jats:styled-content> in moderate\u2010to\u2010severe chronic plaque psoriasis. Guidance on appropriate patient selection, <jats:styled-content style=\"fixed-case\">DMF<\/jats:styled-content> dosage considerations, monitoring and side\u2010effect management is offered based upon available evidence and collective real\u2010world clinical experience.<\/jats:p>","DOI":"10.1111\/jdv.15218","type":"journal-article","created":{"date-parts":[[2018,9,21]],"date-time":"2018-09-21T15:08:05Z","timestamp":1537542485000},"page":"3-14","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["Clinical use of dimethyl fumarate in moderate\u2010to\u2010severe plaque\u2010type psoriasis: a European expert consensus"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9539-0712","authenticated-orcid":false,"given":"U.","family":"Mrowietz","sequence":"first","affiliation":[{"name":"Psoriasis\u2010Centre at the Department of Dermatology University Medical Centre Schleswig\u2010Holstein 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