Among patients with psoriasis who did not achieve Psoriasis Area and Severity Index 50 during the first course of alefacept therapy, 53% achieved Psoriasis Area and Severity Index 50 during the second course (odds rat...Among patients with psoriasis who did not achieve Psoriasis Area and Severity Index 50 during the first course of alefacept therapy, 53% achieved Psoriasis Area and Severity Index 50 during the second course (odds ratio [95% confidence interval]vs placebo 2.30 [1.26- 4.19]). Alefacept provided incremental efficacy over 5 successive 12-week treatment courses.展开更多
An open-label study of alefacept plus ultravioletB light as combination therapy for chronic plaque psoriasis<Author>Ortonne J.P./Khemis A./Koo J./Choi J. [J.P.Ort-onne, l’ Archet II, 15, R. de S. Antoine de Gin...An open-label study of alefacept plus ultravioletB light as combination therapy for chronic plaque psoriasis<Author>Ortonne J.P./Khemis A./Koo J./Choi J. [J.P.Ort-onne, l’ Archet II, 15, R. de S. Antoine de Ginestiere, Nice, Cé dex 03, France]Background: Alefacept, a fully human LFA-3/IgG1 fusion protein, is a selective biological agent approved in theUnited States for the treatment of chronic plaque psoriasis. In phase 3 trials, clinical improvement and prolonged off-treatment remission of psoriasis correlated with reductions in circulating memory T cells. Reductions in pathogenic epidermal T cells in psoriatic lesions also have been noted following phototherapy with ultraviolet B (UVB) light. Because alefacept and UVB target T cells in different ways, combination therapy with these two agents may lead to greater efficacy. Objectives: To determine the safety, tolerability, and efficacy trends of combination therapy with alefacept plus UVB light in patients with chronic plaque psoriasis. Methods: In an open-label, parallel-group study conducted at two sites, one in France and one in the United States, patients with chronic plaque psoriasis who were candidates for phototherapy received 12-weekly intramuscular injections of alefacept, 15 mg. In addition, patients were randomized to one of three treatment arms: no UVB treatment, 6-week UVB treatment, and 12-week UVB treatment. UVB treatment consisted of narrowband (NB) UVB at the site in France and broadband (BB) UVB at the site in the United States. The 12-week treatment period was followed by a 12-week follow-up period. Clinic visits occurred weekly during treatment and every 2-4 weeks during follow-up. Results: A total of 60 patients (n =30/site)were enrolled in the study. Alefacept was well tolerated when administered in combination with UVB treatment and as monotherapy. There was no evidence of increased phototoxicity or photosensitivity with the combination. At each study site, alefacept/UVB provided a higher overall response rate and led to a more rapid onset of response compared with alefacept monotherapy. Of patients who achieved ≥ 50% reduction from baseline Psoriasis Area Severity Index (PASI 50) at 2 weeks after the last dose of alefacept, 75-100% in the combination therapy groups maintained this response throughout followup in the absence of further psoriasis therapy. Conclusions: In patients with chronic plaque psoriasis, combination therapy with alefacept plus short-term (6-12 weeks) UVB treatment is well tolerated with a trend toward greater and more rapid efficacy than alefacept alone.<Keywords>展开更多
Alefacept is a dimeric fusion protein that consists of the extracellular CD2-binding portion of human lymphocyte function-associated antigen-3, which is linked to the Fc segment of human IgG1.1 Alefacept inhibits T-ce...Alefacept is a dimeric fusion protein that consists of the extracellular CD2-binding portion of human lymphocyte function-associated antigen-3, which is linked to the Fc segment of human IgG1.1 Alefacept inhibits T-cell activation and proliferation, and induces apoptosis of memory-effector (CD45RO+) T cells in vitro,2 limiting the inflammatory and uncontrolled keratinocyte proliferation seen in psoriatic lesions. Alefacept is the first biologic approved in the United States for the treatment of moderate to severe chronic plaque psoriasis. This report describes the use of alefacept in 2 patients with extensive and recalcitrant palmoplantar psoriasis who achieved significant improvements on alefacept therapy.展开更多
文摘Among patients with psoriasis who did not achieve Psoriasis Area and Severity Index 50 during the first course of alefacept therapy, 53% achieved Psoriasis Area and Severity Index 50 during the second course (odds ratio [95% confidence interval]vs placebo 2.30 [1.26- 4.19]). Alefacept provided incremental efficacy over 5 successive 12-week treatment courses.
文摘An open-label study of alefacept plus ultravioletB light as combination therapy for chronic plaque psoriasis<Author>Ortonne J.P./Khemis A./Koo J./Choi J. [J.P.Ort-onne, l’ Archet II, 15, R. de S. Antoine de Ginestiere, Nice, Cé dex 03, France]Background: Alefacept, a fully human LFA-3/IgG1 fusion protein, is a selective biological agent approved in theUnited States for the treatment of chronic plaque psoriasis. In phase 3 trials, clinical improvement and prolonged off-treatment remission of psoriasis correlated with reductions in circulating memory T cells. Reductions in pathogenic epidermal T cells in psoriatic lesions also have been noted following phototherapy with ultraviolet B (UVB) light. Because alefacept and UVB target T cells in different ways, combination therapy with these two agents may lead to greater efficacy. Objectives: To determine the safety, tolerability, and efficacy trends of combination therapy with alefacept plus UVB light in patients with chronic plaque psoriasis. Methods: In an open-label, parallel-group study conducted at two sites, one in France and one in the United States, patients with chronic plaque psoriasis who were candidates for phototherapy received 12-weekly intramuscular injections of alefacept, 15 mg. In addition, patients were randomized to one of three treatment arms: no UVB treatment, 6-week UVB treatment, and 12-week UVB treatment. UVB treatment consisted of narrowband (NB) UVB at the site in France and broadband (BB) UVB at the site in the United States. The 12-week treatment period was followed by a 12-week follow-up period. Clinic visits occurred weekly during treatment and every 2-4 weeks during follow-up. Results: A total of 60 patients (n =30/site)were enrolled in the study. Alefacept was well tolerated when administered in combination with UVB treatment and as monotherapy. There was no evidence of increased phototoxicity or photosensitivity with the combination. At each study site, alefacept/UVB provided a higher overall response rate and led to a more rapid onset of response compared with alefacept monotherapy. Of patients who achieved ≥ 50% reduction from baseline Psoriasis Area Severity Index (PASI 50) at 2 weeks after the last dose of alefacept, 75-100% in the combination therapy groups maintained this response throughout followup in the absence of further psoriasis therapy. Conclusions: In patients with chronic plaque psoriasis, combination therapy with alefacept plus short-term (6-12 weeks) UVB treatment is well tolerated with a trend toward greater and more rapid efficacy than alefacept alone.<Keywords>
文摘Alefacept is a dimeric fusion protein that consists of the extracellular CD2-binding portion of human lymphocyte function-associated antigen-3, which is linked to the Fc segment of human IgG1.1 Alefacept inhibits T-cell activation and proliferation, and induces apoptosis of memory-effector (CD45RO+) T cells in vitro,2 limiting the inflammatory and uncontrolled keratinocyte proliferation seen in psoriatic lesions. Alefacept is the first biologic approved in the United States for the treatment of moderate to severe chronic plaque psoriasis. This report describes the use of alefacept in 2 patients with extensive and recalcitrant palmoplantar psoriasis who achieved significant improvements on alefacept therapy.
