Psoriasis: Recommendations for fumaric acid esters

  • There is no FDA-approved use for psoriasis in the United States  
  • Fumaric acid esters are approved in Europe
  • Severe liver disease
  • Severe or chronic GI disease
  • Severe or chronic kidney disease
  • Malignancy or a history of malignancy
  • Leukopenia and other hematologic abnormalities
  • Pregnancy
  • Breast-feeding

Strength of Recommendation: B Level of Evidence: II

Navigate section 4 of the psoriasis guideline: Systemic agents

Citation note

When referencing this guideline in a publication, please use the following citation: Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009 Sep;61(3):451-85. 

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