Alefacept

Abstract

The treatment of immune-mediated and chronic inflammatory diseases of the skin usually involves topical as well as systemic interventions. Although most of these strategies allow for effective disease control they are frequently associated with sometimes severe side effects. Therefore, there is continuous need for novel efficient therapies with a favorable safety profile. The recent progress in the understanding of the complex pathomechanisms underlying chronic inflammation and the major advances in biotechnology prompted the development of several novel compounds targeting autoantigen recognition and autoantibody production, cytokine function and production, tolerance induction, and gene transcription. Among several novel therapeutic avenues, the development of biologic agents (biologics) in particular has expanded recently. Strategies for biologic therapy are multiple and may consist of mediators that promote immune deviation, agents that inhibit the effects of proinflammatory cytokines, compounds that target pathogenic T cells and agents that disrupt the antigen-presentation/T-cell activation. Although most of these developments aimed to the improve graft rejection and the treatment of autoimmune diseases, more recently several compounds have primarily been developed for the treatment of chronic inflammatory skin diseases such as psoriasis, which like rheumatoid arthritis (RA), Crohn’s disease, and uveitis, is regarded as an immunemediated inflammatory disease (IMID). Accordingly, alefacept (LFA-3TIP) and efalizumab (anti-CD11a) have been developed for the treatment of psoriasis and now are approved in many countries. This chapter will briefly review the efficacy and safety of alefacept in the treatment of psoriasis and related inflammatory diseases.