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09 April 2018

Skilarence (Dimethyl Fumarate) - SMC Publishes Advice on Fumaric Acid Treatment for Psoriasis

The Scottish Medicines Consortium (SMC) recommends Skilarence (Dimeythl Fumarate) for the treatment of moderate to severe plaque psoriasis in Scotland.

On 9th April 2018, the Scottish Medicines Consortium (SMC) published its decision to recommend the fumaric acid medication Skilarence (also known by its generic name, Dimethyl Fumarate) as a treatment option for adults with moderate to severe plaque psoriasis in Scotland.

Skilarence is recommended for adults whose psoriasis has not responded to conventional non-biologic systemic treatments (including ciclosporin, methotrexate and acitretin), or who cannot tolerate these treatments, and who are considered unsuitable for biologic treatments given their current disease state or personal preference.

Some people with psoriasis may be aware of a similar treatment, known as Fumaderm or Fumaric Acid Esters. This is a German treatment that is not licensed in the UK, but has sometimes been prescribed on a case-by-case basis. Skilarence is licensed in the UK, and uses the main active ingredient from Fumaderm.

Today’s SMC recommendation, along with NICE’s approval of Skilarence to treat psoriasis in England and Wales in 2017, should make fumaric acid ester treatment more accessible to people with psoriasis in the UK.

How does Skilarence work?

It is not known exactly how Skilarence works in psoriasis. In psoriasis, certain processes in the immune system are overactive – either by working more quickly than in someone without psoriasis, or by producing more inflammatory chemicals. Fumaric acid esters (FAEs) such as Skilarence interrupt these processes, reducing the amount of inflammation in the body and, ultimately, improving psoriasis.

How is Skilarence used?

Skilarence is taken by mouth in tablet form. The dosing regimen is as follows:

  • Week One: One 30mg tablet, once a day
  • Week Two: One 30mg tablet, twice a day
  • Week Three: One 30mg tablet, three times a day
  • Week Four: One 120mg tablet, once a day.

This may then be increased over the next five weeks, until a maximum dose of 240mg three times a day is reached. Not everyone will need to be on the highest possible dose if lower doses are effective.

People who are offered Skilarence will have blood and urine tests before they start the treatment. They will also have blood and urine tests regularly whilst taking Skilarence, to check for any blood, liver or kidney complications.

For more information about Skilarence, have a read of our information sheet.