title: Systemic antipsoriatic combination therapy with fumaric acid esters for plaque-type psoriasis: report on 17 cases.
abstract: BACKGROUND
  In the literature as well as in existing psoriasis guidelines, only little evidence is available on combination regimens with systemic antipsoriatic agents. However, if systemic monotherapy is not efficacious enough to control the disease, a combination therapy might be necessary.
  
  
  OBJECTIVE
  To evaluate the use of fumaric acid esters (FAEs) in combination with other antipsoriatic agents in 6 specialized dermatological departments in Germany.
  
  
  METHODS
  A systematic retrospective chart review of patients receiving FAEs was performed.
  
  
  RESULTS
  A total of 17 cases of patients receiving FAEs combined with at least one other systemic therapy (methotrexate, acitretin, etanercept, cyclosporine, leflunomide and infliximab) to treat psoriasis or psoriatic arthritis were identified.
  
  
  CONCLUSIONS
  FAEs can be combined in an off-label setting with conventional as well as biological agents to treat recalcitrant psoriasis or psoriatic arthritis. Safety monitoring should be taken seriously as no controlled data for these combination regimens exist.
authors: Department of Dermatology and Allergy, University of Bonn, Bonn, Germany.
authors: Dagmar
authors: D
authors: Wilsmann-Theis
authors: Yvonne
authors: Y
authors: Frambach
authors: Sandra
authors: S
authors: Philipp
authors: Ansgar J
authors: AJ
authors: Weyergraf
authors: Arnd
authors: A
authors: Jacobi
authors: Rotraut
authors: R
authors: Mössner
authors: Sascha
authors: S
authors: Gerdes
mesh_terms: D017255:Acitretin / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D005858:Germany; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D007555:Isoxazoles / Q000627:therapeutic use; D007641:Keratolytic Agents / Q000627:therapeutic use; D000077339:Leflunomide; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D005650:Fumarates; D007555:Isoxazoles; D007641:Keratolytic Agents; D016572:Cyclosporine; D011239:Prednisolone; D000069285:Infliximab; D000077339:Leflunomide; D017255:Acitretin; D000068800:Etanercept; D008727:Methotrexate