title: Update on alefacept safety.
abstract: BACKGROUND
  Alefacept has been demonstrated in clinical trials to be an effective, safe, and well-tolerated treatment strategy when used alone or in combination with other antipsoriatic therapies in patients with chronic plaque psoriasis.
  
  
  OBJECTIVE
  AWARE (Amevive Wisdom Acquired from Real-World Evidence) is a multicenter, observational, Canadian phase IV registry evaluating the efficacy and safety of alefacept, alone or in combination with other antipsoriatic therapies, in patients with psoriasis.
  
  
  METHODS
  Patients with chronic plaque psoriasis were treated with at least one course of alefacept followed by an off-treatment period, typically lasting 12 or more weeks. Prospective follow-up was at least 60 weeks, depending on when patients presented for retreatment. Safety data collected throughout the study included the incidence of serious adverse events (SAEs), dosing suspensions, and withdrawals owing to adverse events.
  
  
  RESULTS
  Twelve SAEs were reported in psoriasis patients treated with at least one course of alefacept, with only one considered to be possibly related to the study drug. Approximately one-quarter of patients missed at least one dose of alefacept during the course of the study. A total of 291 doses of alefacept were missed, representing almost 4% of the total doses administered in this group of patients. Low CD4(+) count was the most frequent reason for missed doses; however, no patient had persistently low CD4(+) counts requiring permanent discontinuation of alefacept treatment. Seven patients in the AWARE registry discontinued treatment with alefacept, with the most common reason being patient request.
  
  
  CONCLUSIONS
  The AWARE study supports the safety of alefacept used alone or in combination with other antipsoriatic therapies, in a broad population of real-world chronic plaque psoriasis patients in Canada.
authors.affiliation: Wellington Dermatology Association, London, ON. denisewexler@hotmail.com
authors.forename: Denise
authors.initials: D
authors.lastname: Wexler
authors.forename: Gordon
authors.initials: G
authors.lastname: Searles
authors.forename: Ian
authors.initials: I
authors.lastname: Landells
authors.forename: Neil H
authors.initials: NH
authors.lastname: Shear
authors.forename: Robert
authors.initials: R
authors.lastname: Bissonnette
authors.forename: Kim
authors.initials: K
authors.lastname: Papp
authors.forename: Yves
authors.initials: Y
authors.lastname: Poulin
authors.forename: Richard
authors.initials: R
authors.lastname: Langley
authors.forename: Wayne P S
authors.initials: WP
authors.lastname: Gulliver
mesh_terms: D000077944:Alefacept; D002170:Canada / Q000453:epidemiology; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D011993:Recombinant Fusion Proteins; D000077944:Alefacept