An extended 16-week course of alefacept in the treatment of chronic plaque psoriasis

Alefacept with methotrexate for treatment of psoriatic arthritis: Open-label extension of a randomized, double-blind, placebo-controlled study

“…The adverse event profile caused by a second course of alefacept was similar to that reported previously for the doubleblind phase of the study. 22 Similar to previous reports on patients with psoriasis receiving multiple alefacept courses, [26][27][28][29] some patients in this extension study had transient elevation of liver enzymes. However, as with the studies examining psoriasis, there was no evidence of increased risk of hepatotoxicity in response to treatment with alefacept.…”

Recent Trends in Systemic Psoriasis Treatment Costs

“…Published cost-effectiveness analyses have demonstrated annual costs for psoriasis medication of up to $37 000; however, these analyses included costs for treatment regimens that are often prescribed but not currently published as recommended regimens, such as adalimumab, 40 mg weekly, or efalizumab, 2 mg/kg subcutaneously weekly. 9,16 Indeed, using our cost model, we calculated an annual cost of $48 530 for efalizumab, 2 mg/kg subcutaneously weekly.…”

“…When they factored in considerations of safety, the authors suggested UV-B phototherapy as the first-line agent of choice for severe psoriasis because of the higher risk profile of methotrexate. Regarding the cost-effectiveness of biologic therapies, studies 16,23 suggest that adalimumab and infliximab are the most cost-effective biologic therapies, whereas efalizumab and alefacept are the least cost-effective on the basis of the PASI-75 analyses. Similar results were obtained by Sizto and coworkers, 40 who demonstrated that infliximab provided the greatest increase in quality-adjusted life-years (QALYs) relative to supportive care (0.18 QALY), followed by adalimumab (0.16 QALY).…”

Alefacept revisited: Our 3-year clinical experience in 200 patients with chronic plaque psoriasis

“…6,7 Alternative dosage regimens in clinical practice, including extended dosing beyond 12 weeks, higher dosing, and treatment courses involving concomitant therapy for psoriasis, can potentially provide additional benefit without compromising the safety profile of alefacept. [8][9][10] More than 200 patients with plaque psoriasis have been treated with alefacept in our clinic, using several different dosing regimens, including combination with phototherapy or conventional systemic therapies, especially in a sequential therapeutic approach, with the aim of discontinuing the prior traditional agent during the alefacept course. 11 This report describes our clinical experience during 3 years involving alefacept treatment, including alternate dosage regimens, in patients with moderate to severe chronic plaque psoriasis, the majority of whom were also maintained on appropriate topical therapy, as needed.…”