Long-term use of intravenous alefacept: safety and off-treatment responses in patients who have received four or more courses of therapy

Integrating Biologic Agents into Management of Moderate-to-Severe Psoriasis: A Consensus of the Canadian Psoriasis Expert Panel

“…9,67 Retreatment data for up to nine courses of alefacept 7.5 mg IV are available from an ongoing multicenter open-label extension that includes patients who completed phase II trials with alefacept. 68 Health Related Quality of Life was assessed in a phase II, multicenter, randomized, placebo-controlled, doubleblind study involving 229 patients with moderate-to-severe chronic plaque psoriasis. The study demonstrated a dose-dependent improvement in DLQI, DQOLS, and SF-36 in patients receiving alefacept IV (0.025-0.15 mg/ kg) compared with those receiving placebo.…”

Patient Satisfaction with Psoriasis Therapies: An Update and Introduction to Biologic Therapy

“…50 There also is evidence to support the use of repeated courses of alefacept. 51 Efalizumab, an agent that inhibits multiple T-cellmediated activities, also has shown favorable efficacy in clinical trials (reviewed by Weinberg 46 ). In two phase III, randomized, placebo-controlled trials, PASI-75 responses were achieved in 27% and 22% of patients after 12 weekly subcutaneous (SC) injections with efalizumab 1 mg/kg/wk, compared with 4% and 5% of patients receiving placebo, respectively.…”

The efficacy of multiple courses of alefacept in patients with moderate to severe chronic plaque psoriasis

“…Although the number of patients decreased by course, the reasons for patients not continuing from one course to the next varied and included prolonged response, personal reasons, lost to follow-up, lack of efficacy, and adverse events. Prior studies have shown the tolerability and safety of alefacept over multiple courses 1,3,8,9 to be similar to that after a single course. 1,2,10 A limitation of our analysis is that the studies evaluated alefacept monotherapy and that the third through fifth courses were open-label and uncontrolled.…”

“…8,9 Tachyphylaxis was not observed after repeated courses of alefacept, as dose escalation was not necessary to maintain or improve clinical response. Although the number of patients decreased by course, the reasons for patients not continuing from one course to the next varied and included prolonged response, personal reasons, lost to follow-up, lack of efficacy, and adverse events.…”