An open-label study evaluating the efficacy and tolerability of alefacept for the treatment of scalp psoriasis

Krell, James; Nelson, Candi; Spencer, Linda V.; Miller, S.A.

doi:10.1016/j.jaad.2007.12.031

Cited by 28 publications

(15 citation statements)

References 24 publications

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“…The only data regarding their safety and true efficacy in scalp psoriasis are derived from clinical experience and small case series, which showed minimal improvement of scalp psoriasis. 39 Thus, they should be reserved for individuals with severe disease that is refractory to first-line therapies.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, these medications should be reserved for patients with severe, recalcitrant scalp psoriasis Biologics (adalimumab, alefacept, efalizumab, etanercept, infliximab) Lebwohl 37 IV Krell et al 39 IIB d Open-label study; 30 pts received 15 mg alefacept IM wkly for 16 wk, followed by 12 wk of alefacept if they did not achieve or maintain clearing d 5 pts (16.7%) achieved clearing or partial clearing on scalp Physician's Global Assessment after first course of therapy; 8 pts (26.7%) clear or almost clear after second course d Side effects: 1/30 pts experienced nausea/GI upset/malaise GI, Gastrointestinal; IM, intramuscular (administration); PASI, Psoriasis Area and Severity Index; for other abbreviations, see Table I. J AM ACAD DERMATOL VOLUME 60, NUMBER 6 therapy would be effective, can be used intermittently, and be safe for long-term treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of severe scalp psoriasis: From the Medical Board of the National Psoriasis Foundation

Chan

Voorhees

Lebwohl

et al. 2009

Journal of the American Academy of Dermatology

106

114

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of severe scalp psoriasis: From the Medical Board of the National Psoriasis Foundation

Chan

Voorhees

Lebwohl

et al. 2009

Journal of the American Academy of Dermatology

106

114

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“…There are also photo-and radiotherapies available for scalp psoriasis (ultraviolet B light, psoralen + ultraviolet A, excimer laser and grenz rays), and emerging data support the efficacy of systemic biological agents such as infliximab 10 and alefacept. 11 The use of biological agents is currently limited to patients with widespread psoriasis [> 10% body surface area affected, or Psoriasis Area Severity Index (PASI) > 10], based on the available data and the cost of these therapies. Few well-designed trials have assessed the efficacy and safety of treatment; the strongest evidence is available for topical corticosteroids and vitamin D3 analogues.…”

Section: Current Treatments For Scalp Psoriasismentioning

confidence: 99%

“…Similarly, although few studies are currently available on the use of systemic biological therapies in the treatment of scalp psoriasis, and the use of these agents may be limited by their high cost, early data appear promising. 10,11,56 The combination of systemic therapy and topical therapy may be useful in some cases.…”

Section: Guidance For Using the Algorithmmentioning

confidence: 99%

Scalp psoriasis: European consensus on grading and treatment algorithm

Chimenti

Luger

et al. 2009

Acad Dermatol Venereol

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The scalp is a common site of involvement of psoriasis and, for many patients, is a challenging aspect of their disease.This can be attributed not only to the scaling, itching and cosmetic embarrassment that go with scalp psoriasis, but also to the fact that the scalp skin is relatively inaccessible, making topical therapies difficult to apply. The proximity of sensitive facial skin can also limit the use of potentially irritating topical treatments. Nevertheless, the specific challenges of scalp psoriasis are often neglected by treatment guidelines. This paper summarizes the discussions that took place at an international conference of experts convened in Geneva, Switzerland, in March 2008. The objective of the meeting was to review the available treatments for scalp psoriasis in terms of efficacy, safety, convenience, and the implications for patient compliance with treatment. In addition, definitions of mild, moderate and severe scalp psoriasis were agreed. This paper presents a treatment algorithm that includes recommendations for patients in all three categories. It considers the role of potent topical corticosteroids, vitamin D3 derivatives, salicylic acid preparations, and photo-and radiotherapy, as well as systemic therapies, including newer biological agents, for patients with widespread psoriasis with scalp involvement. Data from clinical trials indicate that a potent topical corticosteroid in a short-contact formulation is the most appropriate treatment for most patients with scalp psoriasis.

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“…Systemic therapies including oral retinoids, methotrexate, cyclosporine and fumaric acid esters lack evidence-based data on the efficacy and safety in scalp psoriasis, although they are effective in the treatment of generalized psoriasis [11,12]. Biological agents which block tumour necrosis factor such as etanercept, infliximab and adalimumab have the longest established clinical experience; however, their use in scalp psoriasis is based on low-level evidence [13,14]. Interestingly, the Delphi consensus considers the use of biological agents in scalp psoriasis due to their impact on the DLQI [15].…”

Section: Discussionmentioning

confidence: 99%

Ustekinumab Induces Fast Response and Maintenance of Very Severe Refractory Scalp Psoriasis: Results in Two Greek Patients from the Psoriasis Hospital-Based Clinic

Papadavid¹,

Ferra²,

Koumaki³

et al. 2014

Dermatology

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Background: Scalp psoriasis, one of the most common sites of psoriasis involvement, is often difficult to control with topical agents. There is a lack of substantial evidence-based data for the efficacy and safety of systemic therapies. Methods: Two patients from our university-based psoriasis clinic with chronic plaque psoriasis and severe recalcitrant scalp involvement were assessed by Psoriasis Area and Severity Index and Psoriasis Scalp Severity Index scores, respectively, and quality of life by the Dermatology Life Quality Index. Results: We report 2 psoriasis patients with very severe scalp psoriasis who developed a fast clinical response of scalp psoriasis to ustekinumab in 8 weeks with excellent patient adherence up to 28 weeks of follow-up and positive impact on quality of life due to rapid and long-term clearing. Conclusion: Ustekinumab produces a fast clinical response of recalcitrant scalp psoriasis with excellent patient adherence and a positive impact on quality of life due to rapid and long-term clearing in patients with very severe scalp involvement who failed conventional topical and systemic treatment.

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An open-label study evaluating the efficacy and tolerability of alefacept for the treatment of scalp psoriasis

Cited by 28 publications

References 24 publications

Treatment of severe scalp psoriasis: From the Medical Board of the National Psoriasis Foundation

Treatment of severe scalp psoriasis: From the Medical Board of the National Psoriasis Foundation

Scalp psoriasis: European consensus on grading and treatment algorithm

Ustekinumab Induces Fast Response and Maintenance of Very Severe Refractory Scalp Psoriasis: Results in Two Greek Patients from the Psoriasis Hospital-Based Clinic

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