Tablets containing fumaric acid esters lead to improvement of psoriasis in children and adolescents

Linked Article:   Hamm et al . Br J Dermatol 2021; 185 :62–73. Psoriasis is an inflammatory skin disease that can begin during childhood. In Germany, psoriasis affects seven out of 1000 children and adolescents. The condition in these young people is challenging to treat because many drugs are only approved for adults. Tablets containing fumaric acid esters are successfully used to treat adults with psoriasis. This study from Germany aimed to find out if fumaric acid esters can also improve psoriasis in children and adolescents. We split 134 patients with psoriasis aged 10–17 years into two groups: 91 patients received tablets containing fumaric acid esters and 43 patients received a similar‐looking placebo tablet without the drug ingredient. After 20 weeks we compared the affected skin area to the situation at the start of the study. We also counted the patients whose skin was clear or almost clear of psoriasis. After 20 weeks, six times more patients from the group receiving fumaric acid esters had clear or almost clear skin compared with the group receiving placebo tablets (42% vs. 7%). Compared with at the study start, 55% of patients treated with fumaric acid esters and 19% of patients receiving placebo tablets achieved a 75% reduction of severity of their skin disease. There were more side‐effects in patients receiving fumaric acid esters. Most of them affected the stomach and bowel and were mild. Our study shows that tablets containing fumaric acid esters lead to improvement of psoriasis in children and adolescents. Additional studies with more patients and longer study duration are necessary to confirm these effects.