Efalizumab in the Treatment of Psoriasis

Abstract

Background: Efalizumab (anti-CD11a), a targeted, reversible T-cell modulator, is a humanized monoclonal antibody that provides a rapid onset of action of clinical benefit and has been studied up to 36 months, showing continuous control of plaque-type psoriasis. Efalizumab has recently been approved in Canada for this indication. Objective: To examine the efficacy and safety of efalizumab by presenting the latest data in the treatment of psoriasis. Methods: We searched MEDLINE (1966–2005) for randomized, double-blind studies of efalizumab (1 mg/kg for 12 weeks) using the following key words: psoriasis, efalizumab, biologics, and treatment. Results: It was found that the proportion of patients who achieved Psoriasis Area and Severity Index (PASI) 75 and PASI 50 ranged from 22 to 39% and 52 to 61%, respectively. PASI 75 improvement was achieved in 44% of patients, who continued to receive efalizumab by week 24. Following 36 months of continuous treatment, a PASI 75 response was achieved by 45% (intent-to-treat [ITT] analysis), 59% (maintenance group analysis), and 73% (as-treated analysis). Its safety profile was similar during the 12-week and 36-month treatment periods. Conclusions: Currently, more than 3,500 patients have received efalizumab in clinical trials. Efalizumab may be an important treatment option for dermatologists seeking to provide a well-tolerated and effective treatment modality for patients with moderate to severe chronic plaque psoriasis.