Alefacept

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Immunosuppressively active fusion protein (dimer) consisting of an extracellular CD2 binding site of leukocyte functional antigen 3 (LFA-3) and portions of IgG1

Pharmacodynamics (Effect)
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Inhibition of lymphocyte activation by specific binding to CD2 and inhibition of LFA-3/CD2 interaction. Reduction of CD2+ T lymphocytes, especially CD45 RO+ cells, probably by binding of CD2 to target cells and the Fc fragments on cytotoxic cells, especially NK cells.

Indication
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For moderately severe and severe forms of psoriasis vulgaris that require systemic treatment ( off-label use, not permitted in Europe!).

Pregnancy/nursing period
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Insufficient data on use in pregnancy and lactation are available. Should not be prescribed during pregnancy and lactation.

Complication(s)
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Lymphocytopenia (dose-dependent, especially with CD4 and CD8 cells)!

Cave! Weekly control of lymphocyte subpopulations, especially CD4 lymphocytes in the differential blood count!

Dosage and method of use
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Once/week 7.5 mg Alefacept i.v. or once/week 15 mg i.m. for 12 weeks.If necessary, repeat the therapy cycle after a 12-week therapy break.

Contraindication
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Lymphocytopenia with planned therapy start.

Preparations
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Amevive

Literature
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  1. Cather JC et al (2003) Investigational therapies for psoriasis. J Am Acad Dermatol 49: S133-138
  2. Craze M et al (2003) Integrating biologic therapies into a dermatology practice: practical and economic considerations. J Am Acad Dermatol 49: S139-142
  3. Frampton J, Wagstaff A (2003) Alefacept Am J Clin Dermatol 4: 277-286
  4. Gottlieb AB (2003) CD4+ T-cell-directed antibody responses are maintained in patients with psoriasis receiving alefacept: Results of a randomized study. J Am Acad Dermatol 49: 816-825
  5. Gottlieb AB, Bos JD (2002) Recombinantly engineered human proteins: transforming the treatment of psoriasis. Clin Immunol 105: 105-116
  6. Krueger GG, Ellis CN (2003) Alefacept therapy produces remission for patients with chronic plaque psoriasis. Br J Dermatol 148: 784-788
  7. Krueger GG, Callis KP (2003) Development and use of alefacept to treat psoriasis. J Am Acad Dermatol 49: S87-97
  8. Vaishnaw AK et al (2002) Pharmacokinetics, biologic activity, and tolerability of alefacept by intravenous and intramuscular administration. J Pharmacokinet Pharmacodyn 29: 415-426
  9. Weinberg JM, Tutrone WD (2003) Biologic therapy for psoriasis: the T-cell-targeted therapies efalizumab and alefacept. Cutis 71: 41-45

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Last updated on: 29.10.2020