Efalizumab for the treatment of moderate to severe plaque psoriasis.
OBJECTIVE
To review the pharmacology, efficacy, and safety of efalizumab for the treatment of moderate to severe plaque psoriasis.


METHODS
A MEDLINE search (1966-May 2005) using the key words hu1124, anti-CD11a, efalizumab, Raptiva, Xanelim, and psoriasis was conducted. References of identified articles were reviewed for additional citations.


METHODS
Clinical trials evaluating the pharmacology, efficacy, and safety of efalizumab for treatment of moderate to severe plaque psoriasis in adults were included in our review.


RESULTS
Efalizumab's ability to inhibit the binding of CD11a, a subunit of leukocyte function-associated antigen type 1, to intracellular adhesion molecule 1 results in decreased T-cell activation and migration, 2 key steps in the immunopathogenesis of psoriasis. Results of clinical trials have demonstrated that efalizumab administered subcutaneously is a safe and effective treatment for moderate to severe plaque psoriasis. Efalizumab was well tolerated in trials, with the majority of adverse events arising with the first dose and decreasing with subsequent doses. The high cost of this agent and lack of head-to-head trials with other drugs will likely restrict its use to patients who have failed prior systemic therapy or phototherapy.


CONCLUSIONS
Efalizumab is a safe and effective therapy for treatment of moderate to severe plaque psoriasis in patients who have failed prior systemic therapy or phototherapy.
Jordan
Joseph K
JK
Department of Pharmacy, Clarian Health Partners/Purdue University, I-65 at 21st St., RM AG401, Indianapolis, IN 46202-5306, USA. jjordan1@clarian.org
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002626:Chemistry, Pharmaceutical; D002648:Child; D002986:Clinical Trials as Topic; D000075202:Contraindications; D004347:Drug Interactions; D005260:Female; D006801:Humans; D010353:Patient Education as Topic; D011247:Pregnancy; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C472181:efalizumab