Treatment: Biologics
Alefacept

FDA approved to treat:

  • Adults with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.

What’s involved in taking alefacept:

  • Intramuscular injection given in a doctor’s office once a week for 12 weeks.

  • Screenings tests for the hepatitis B virus and latent (not causing symptoms) tuberculosis (TB) are conducted before alefacept is prescribed.

  • Patients taking alefacept are closely monitored and must get regular blood tests to check their T cell (a type of white blood cell) counts.

How alefacept works: Alefacept blocks the activation of certain T cells, a type of white blood cell that plays an important role in the body’s immune system. Blocking activation of select T cells prevents the triggering of faulty signals that cause the inflammation, redness, and other signs of psoriasis.

Effectiveness: Studies conducted to obtain approval from the U.S. Food and Drug Administration (FDA) have found:

  • Skin clearing. About 20% of patients see a 75% or greater clearing, and approximately 40% achieve at least 50% clearing.

  • Improvement gradual. Patients usually do not see significant improvement for about 2 months. One study found that 53% of patients who did not see a 50% or greater improvement during the first 12-week course of alefacept saw a 50% or greater improvement with a second course of alefacept.

  • Long remission. For a small group of patients, alefacept provides a long period of remission. The average remission period in clinical trials for those who responded was more than 7 months. Some remissions exceeded one year. Once remission lapses, a repeat 12-week course of therapy can be given if 12 weeks have passed since the last shot.

Safety and side effects: In clinical trials, alefacept has a good overall safety profile. Most side effects are mild and do not cause patients to stop taking alefacept. Common side effects include chills, muscle aches, sore throat, nausea, and dizziness. These occur most often after the first few injections and tend to subside with subsequent shots.

A few more serious side effects have been reported. In clinical trials, the most serious side effects were a significant reduction in the number of white blood cells that fight infections and serious infections that required hospitalization. Rare reports of cancer have been made. In one study, of the 1,869 patients who received alefacept, 43 were diagnosed with cancer. Most of the cancers were nonmelanoma skin cancers.

References:
Kipnis CD et al. “Biologic treatments for psoriasis.” Journal of the American Academy of Dermatology. 2005 April;52(4):671-682.

Krueger GG et al. “Development and use of alefacept to treat psoriasis.” Journal of the American Academy of Dermatology. 2003. August;49(2 Suppl):S87-97.

Menter A et al. “The efficacy of multiple courses of alefacept in patients with moderate to severe chronic plaque psoriasis.” Journal of the American Academy of Dermatology. 2006. January;54(1):61-63
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All content solely developed by the American Academy of Dermatology

 

For an overview, visit the AAD pamphlet Psoriasis and Psoriatic Arthritis.

 

 
 

 
 

 

 

 

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Page last updated 4/10/07

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