Efalizumab

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Information about Efalizumab

Efalizumab is a humanized monoclonal antibody to human CD11a subunit of the lymphocyte function-associated antigen 1, which acts as an immunosuppressant agent blocking lymphocyte activation and was formerly used to treat severe plaque psoriasis. 

Liver safety of Efalizumab

Efalizumab has been linked to rare instances of idiosyncratic acute liver injury and may be a rare cause of reactivation of hepatitis B.

== Mechanism of action of Efalizumab ==  Efalizumab (ef” al iz’ ue mab) is a recombinant, humanized monoclonal antibody to CD11a, a subunit of the lymphocyte function-associated antigen 1 (LFA-1), which is present on lymphocytes and causes activation and proliferation of lymphocytes.  Blocking of CD11a inhibits lymphocyte activation and decreases migration of lymphocytes to sites of inflammation.  Efalizumab has been shown to have potent immunosuppressive activity and to lower lymphocyte counts and improve autoimmune conditions.  In controlled studies, efalizumab was shown to be effective in inducing clinical responses in 20% to 30% of patients with severe psoriasis. 

FDA approval information for Efalizumab

Efalizumab was approved for use in the United States in 2005 as therapy for severe plaque psoriasis, but was withdrawn in 2009 because of several instances of progressive multifocal leukoencephalopathy (PMLE), a severe neurological condition which is believed to be due to reactivation of the JC virus in neural cells. 

Brand name for Efalizumab

Efalizumab was previously available in 125 mg single use vials under the brand name Raptiva. 

Dosage and administration for Efalizumab

The recommended initial dose was 0.7 mg/kg subcutaneously, followed by weekly doses of 1 mg/kg, with maximum single dose of 200 mg. 

Side effects of Efalizumab

Common side effects included headache, fatigue, fever, muscle and back aches, nausea, acne and hypersensitivity reactions.  Efalizumab is also capable of causing immune suppression, resulting in an increased susceptibility to opportunistic infections.

Antipsoriasis agents

Monoclonal Antibodies IL-17A Antagonists

Tumor Necrosis Factor Antagonists

Other

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Contributors: Prab R. Tumpati, MD