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Fumaric Acid Esters: Not an “Alternative” — Caveat Emptor
from Dave W.

Hiya, Ed!  Long time, no write.  Sorry about that.

What prompted this email is the letter from Kelly L. (and your response) about Fumaric Acid.  Fumaric Acid Esters (FAEs) are very potent DRUGS which are approved for the treatment of moderate-to-severe psoriasis in at least one European country (Germany).  There is nothing "alternative" about this treatment, except for the decade-old information supplied by the likes of Gary Null and/or the Arthritis Trust of America.

FAEs are not in the pipeline to be approved as a treatment in the U.S., as far as I know.  It seems to me that the risk-to-benefit ratio is very similar to methotrexate, and so it's doubtful that any company will be applying for approval any time soon, since they would be 'competing' with a long-established therapy with a well-known risk profile.

I believe that FAEs can be purchased (in pill form only) from the manufacturer in Germany, and shipped to dermatologists here in the U.S., on an "experimental" basis, but I'm not at all sure of the paperwork requirements for legally importing foreign prescription drugs.  I know of at least one person in New Zealand who used FAEs for a while on this sort of basis (with mixed results, if I remember correctly).

Again, FAEs are serious drugs with potentially-serious side effects.  Nothing to take lightly at all, and not something which everyone will want to try.

That old Arthritis Trust article reprinted on Gary Null's website paints a rosy picture indeed, but the reality of the matter isn't so bright for most of us.  For example, unless my psoriasis becomes much more widespread than it is (perhaps 3%), I won't be considering treatment with FAEs, even as a remote possibility.  For me, the risks are simply too high.

By the way, in reference to the quote, "If the skin does not clear up, the patient is either not taking his medication correctly (that is too little medication), or he/she is not sticking to the diet, or the diagnosis is incorrect," that is probably the only reason Dr. Helmut Christ was able to claim "100% success" — he blamed any failures on the patient or the diagnosis, and didn't entertain the possibility that the drugs/diet/exercise combo simply didn't work for everyone.  That's bad doctoring, and very bad science.  Similar claims abound for the hundreds of "alternative" psoriasis treatments, however, and we should learn, as psoriatics, that they are generally a bad sign.

In this case, the real situation (that the suggested diet is unnecessary, and that Dr. Christ was very wrong about the "100% success" claim) was finally figured out through scientific research programs.  Most "alternative" therapies will never go through clinical testing, however, because their promoters are satisfied with glowing testimonials and with the money they make.  The people who've gotten rid of their psoriasis with FAEs are rather lucky that this particular treatment got the proper testing needed to show that it does, indeed, treat psoriasis.

More information (though I need to update the page a bit), can be found at:

http://members.aol.com/psorsite/fumaric.html

Again, sorry for not writing more often.  - Dave W.

*****

Ed’s Response:  Thanks for this research and report, Dave.  Readers:  Dave’s “Psorsite,” described in Other Places here at FlakeHQ, has become a much-visited repository of solid information and opinion about a wide variety of psoriasis treatments and web sites. Dave:  Apology not accepted.  Write more often!

Your point, Dave, about the semantics of “explaining failure” is worth repeating:

[H]e [Dr. Helmut Christ] blamed any failures on the patient or the diagnosis, and didn't entertain the possibility that the drugs/diet/exercise combo simply didn't work for everyone.  That's bad doctoring, and very bad science.  Similar claims abound for the hundreds of "alternative" psoriasis treatments, however, and we should learn, as psoriatics, that they are generally a bad sign.

In this case, the real situation (that the suggested diet is unnecessary, and that Dr. Christ was very wrong about the "100% success" claim) was finally figured out through scientific research programs. 

This appears to be a case where the subject of the pitch has value (fumaric acid esters) but the pitch itself is misleading.

Kelly L.:  If you’re reading this, please let us know how your derm reacted when you discussed fumaric acid ester therapy with him or her. -Ed

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