T-cell modulation for the treatment of chronic plaque psoriasis with efalizumab (Raptiva (TM)): Mechanisms of action

Psoriasis is a chronic, incurable, auto-immune disorder with
cutaneous manifestations. New evidence on the central role of the
immune system in the pathogenesis of psoriasis increasingly
provides insight into pathogenic steps that can be modulated to
provide disease control. Numerous biological therapies are in
various stages of clinical development, with expectation of
providing enhanced safety and efficacy over currently available
psoriasis therapies. Efalizumab, a recombinant humanized monoclonal
IgG1 antibody, is a novel targeted T-cell modulator that inhibits
multiple steps in the immune cascade that result in the production
and maintenance of psoriatic plaques, including initial T-cell
activation and T-cell trafficking into sites of inflammation,
including psoriatic skin, with subsequent reactivation in these
sites. This article reviews the pharmacodynamic, pharmacokinetic
and clinical effects observed during phase I, II and III efalizumab
trials in patients with moderate to severe chronic plaque
psoriasis. Copyright (C) 2004 S. Karger AG, Basel.