NEW YORK (Reuters Health) - The drug alefacept, which in 2003 was the first "biologic" agent approved in the US for the treatment of moderate to severe chronic plaque psoriasis, appears to be a long-term option for certain patients, results of a study suggests.
"Durable remissions -- longer than 3 months -- in psoriasis are rare," senior investigator Dr. Alan Menter told Reuters Health. But now a "look back" study of some 200 patients has shown that alefacept therapy "has the potential to produce treatment-free periods of 6 months or more in a select group of patients," the researcher added.
As reported in the Journal of the American Academy of Dermatology, Menter of the Baylor Research Institute, Dallas, Texas and colleagues studied 201 patients given 296 courses of alefacept over a 3-year period.
Overall 62 (32.6 percent) achieved an excellent response and had, on average, a remission of about 7 months, with a maximum of up to 25 months.
Some 45 percent of these responders had alternate dosing regimens, including extended double-dose or loading double-dose regimens. In addition, 73 percent had concomitant therapy with drugs such as methotrexate during at least 1 of the alefacept courses.
"It is hoped that genetic testing in the future -- pharmacogenomics -- will allow dermatologists to predict which psoriasis patient is best suited to alefacept therapy," Menter commented.
Mild cases of psoriasis can be treated with topical medication, but more serious cases, in which lesions cover more than 10 percent of the body, require treatment with ultraviolet radiation or immunosuppressive drugs. These therapies cannot be used over the long term, however, due to an increased risk of cancer.
Alefacept binds to immune system cells called T lymphocytes and prevents their activation. Studies have shown that these cells play an important role in causing the skin abnormalities, or lesions, that are characteristic of psoriasis.
SOURCE: Journal of the American Academy of Dermatology, January 2008.
