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Skilarence (LAS41008) is an oral, gastro-resistant formulation of dimethyl fumarate (DMF) developed by Almirall for the treatment of moderate-to-severe plaque psoriasis. Unlike the older product Fumaderm, which contains a mixture of dimethyl fumarate and monoethyl fumarate salts, Skilarence contains only dimethyl fumarate as the active ingredient. Upon oral administration, DMF is rapidly converted to its active metabolite, monomethyl fumarate (MMF). The drug exerts its therapeutic effects through immunomodulatory and anti-inflammatory mechanisms, primarily by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant pathway and inhibiting the nuclear factor kappa B (NF-κB) signaling pathway. These actions lead to a shift from a pro-inflammatory Th1/Th17 response to an anti-inflammatory Th2 response, reducing the production of cytokines such as IL-17, IL-23, and TNF-α that drive psoriatic lesions.
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