An Intensive Review on the Management of Psoriasis: Fumaric Acid Esters Analogs

Psoriasis is a recurring skin condition that occurs due to the hyperproliferation of keratinocytes and immune dysregulation. Psoriasis management frequently necessitates using systemic therapies, which include fumaric acid ester analogs (FAEs), methotrexate, TNF inhibitors, and IL-17 inhibitors. The efficacy of FAEs against methotrexate is comparable but has fewer side effects. The most common adverse reactions associated with the treatment of psoriasis are gastrointestinal symptoms (such as bloating), flushing and lymphopenia.Rare but serious adverse reactions may include hepatitis and renal dysfunction. Methotrexate is an effective treatment; however, it has been linked to hepatitis, gastrointestinal adverse effects, and inhibition of the bone marrow in psoriasis patients. TNF Inhibitors NF-NFinhibitors and TNF-17 inhibitors offer comparable efficacy rates and a faster onset of action to those of other agents but come with increased risks of infections and injection site reactions. TNF inhibitors may raise the risk of autoimmune responses, cancer, and seriousinfections. Neutropenia and inflammatory bowel disease may be made worse by IL-17 inhibitors. Treatment-related factors include the mode of administration, the need for monitoring, and any potential financial barriers to access. FAEs are administered orally and require regular monitoring for adverse events, while biologic agents (TNF inhibitors, IL-17 inhibitors) are administered subcutaneously or intravenously and necessitate monitoring for infections and malignancies. FAEs are given orally and need to be monitored for adverse reactions, while biologic agents (TNF inhibitors, IL-17 inhibitors) are given.