title: Patients with moderate to severe plaque psoriasis: one year after the European Medicines Agency recommendation of efalizumab suspension.
abstract: BACKGROUND
  In February 19, 2009, the European Medicines Agency (EMA) had recommended the suspension of the marketing authorization for efalizumab after the occurrence of cases of progressive multifocal leukoencephalopathy.
  
  
  OBJECTIVE
  To explore the efficacy of alternative therapies for psoriasis and the health status of patients who discontinued efalizumab.
  
  
  METHODS
  An observational study was performed on 101 patients. After the EMA communication, efalizumab was discontinued in the following 2-3 months. In agreement with the patients, we decided to either prescribe other treatments or none at all.
  
  
  RESULTS
  After 1 year, 11 patients are still not treated, 63 patients are treated with biologics, and 9 patients are treated with systemic conventional therapies.
  
  
  CONCLUSIONS
  In order to prevent rebound or relapse, various approaches are available, including cyclosporine, methotrexate and biologic therapies. Interestingly, in 11 out of 31 patients who did not receive any systemic drug, psoriasis is still under control, suggesting a long-term effect of efalizumab.
authors.affiliation: Department of Dermatology, University of Rome Tor Vergata, Rome, Italy. MarinaTalamonti@libero.it
authors.forename: M
authors.initials: M
authors.lastname: Talamonti
authors.forename: M
authors.initials: M
authors.lastname: Teoli
authors.forename: E
authors.initials: E
authors.lastname: Botti
authors.forename: G
authors.initials: G
authors.lastname: Spallone
authors.forename: S
authors.initials: S
authors.lastname: Chimenti
authors.forename: A
authors.initials: A
authors.lastname: Costanzo
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D056737:Safety-Based Drug Withdrawals; D012720:Severity of Illness Index; D016896:Treatment Outcome; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D003879:Dermatologic Agents; D016572:Cyclosporine; C472181:efalizumab; D008727:Methotrexate