Efalizumab in the treatment of psoriasis

We present a review of the literature concerning treatment of psoriasis with humanized monoclonal antibody (hu 1124, efaluzimab, Xanelin) against the CD11a component of lymphocyte-function-associated antigen-1 (LFA-1). Efaluzimab inhibits the interaction of CD11a (LFA-1) with various ICAM molecules. Because ICAM-1 (CD54) is expressed on activated endothelial cells and antigen presenting cells (APCs), the antibody inhibits both the APC-T cell interaction and the T- cell adhesion to endothelial cells, their subsequent activation, which results in decreasing of transendothelial migration. Treatment with Efaluzimab was well tolerated and the majority adverse events were dose-related. Adverse events were described as mild at doses of 0.3 mg/kg or less and included mild chills, abdominal discomfort, headache, and fever (flu-like complaints), apart from this white blood cell counts and lymphocyte counts transient increase were observed. Headache was the most common dose-limiting toxicity observed at a single dose of 0.6 mg/kg or higher.