Safety and efficacy of subcutaneously administered efalizumab in adults with moderate-to-severe hand and foot psoriasis: an open-label study.
BACKGROUND
Hand and foot psoriasis may be more disabling than psoriasis at other body locations because of its interference with daily functional activities. Most treatment options have limited efficacy, short duration of response, toxicity, intolerability, or inconvenience.


OBJECTIVE
To investigate whether efalizumab (Raptiva) is efficacious and safe for the treatment of patients with hand and foot psoriasis.


METHODS
Adult patients with moderate-to-severe hand and/or foot psoriasis received a conditioning dose of efalizumab 0.7 mg/kg at week 0 with subsequent doses of efalizumab 1 mg/kg given weekly for 11 additional weeks (total of 12 doses). Patients were followed until week 24 (12 weeks after the last treatment) to monitor safety and efficacy. Static Physician's Global Assessment (PGA) scores were used to measure efficacy. The primary efficacy endpoint was the number of patients achieving a 50% reduction in the global evaluation by static PGA from baseline at week 12.


RESULTS
Ten patients enrolled, six of whom completed the study. Of these six patients, four patients showed overall improvement at 12 weeks, including two patients that achieved 50% improvement overall. At 12 weeks, the hands of two patients and the feet of two patients showed at least 50% improvement from baseline. Efalizumab was well tolerated and there were no serious adverse events.


CONCLUSIONS
Continuous treatment with efalizumab for 12 weeks was safe and efficacious in this open-label study of patients with hand and foot psoriasis.
Varma
Rajat
R
Department of Dermatology, University of Alabama Medical Center, Birmingham, Alabama, USA. rvarma@uabmc.edu
Cafardi
Jennifer A
JA
Cantrell
Wendy
W
Elmets
Craig
C
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D005528:Foot / Q000473:pathology; D006225:Hand / Q000473:pathology; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D012008:Recurrence; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; C472181:efalizumab