Efalizumab for psoriasis?

Psoriasis is a chronic skin disorder characterised by inflammation producing red, thickened areas with a flaky white build-up. Efalizumab is a humanised monoclonal IgG1 antibody that inhibits the binding of T lymphocytes to endothelial cells and their subsequent migration. In patients suffering from plaque psoriasis, there was improvement in 51 - 52% of the efalizumab-treated patients at week 12, compared with 17% of the placebo patients. Efalizumab caused a > 75% improvement in 22 - 28% of psoriasis patients compared with 5% of placebo patients. Efalizumab also improved quality-of-life outcomes. Early studies are also showing benefits with other compounds (alefacept, infliximab and etanercept) in psoriasis. Direct comparative clinical trials will be needed to ascertain which of these agents provides the maximal improvement with the minimal incidence of side effects.