Use of fumaric acid derivatives in Italian reference centers for psoriasis.

BACKGROUND Several therapies are available for psoriasis, including in some countries oral fumaric acid derivatives (FADs). Even if FADs are not available in the Italian market, they can be prescribed and reimbursed by the National Health Service, on request from the treating physician, when considered as a valuable option in selected patient. METHODS We performed a retrospective analysis of the PsoReal registry data, restricted to adult psoriatic patients enrolled between 2009 and 2017. Demographic and clinical data were collected together with information on systemic therapies prescribed for psoriasis, drug shifts and adverse effects. We focused our analysis on FADs compared with other systemic drugs. RESULTS From the registry data, a total of 17,064 patients were extracted, and 11,592 patients (67.9%), fulfilled inclusion criteria. The majority of them had chronic plaque psoriasis, the mean disease duration was 17.1±12.6 years, and the mean PASI was 17.8±10.9, with 51.5% presenting a moderate Ps (PASI between 10 and 20). A total of 36 patients (0.3%) were treated by FADs. The average treatment duration of conventional (9.0±10.0 months) and biological agents (13.7±11.6 months) was lower compared to the duration of FADs (28.1±20.1, P value<0.001). FADs were used at an average dosage of 361.0±146.3 mg/day and FADs treated patients displayed an overall lower healthcare cost compared with other drugs. CONCLUSIONS The current study confirms previous European data about efficacy and safety of FADs and suggests a decrease of healthcare costs for FADs treated patients as compared to other treatments.