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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › IMMUNOSUPPRESSANTS › IMMUNOSUPPRESSANTS › Monoclonal antibodies
efalizumab
L04AG02
Forms & Strengths
- Subcutaneous injection: 125 mg/1.25 mL single-use pre-filled syringe
Adult Dosing
- Initial conditioning dose: 0.7 mg/kg subcutaneously once
- Maintenance dose: 1 mg/kg (maximum 200 mg per injection) subcutaneously once weekly
Pediatric Dosing
- Safety and efficacy not established in pediatric patients under 18 years of age
Indications
- Treatment of moderate to severe chronic plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
Mechanism of Action
- Recombinant humanized monoclonal antibody that binds to CD11a, inhibiting leukocyte function-associated antigen-1 (LFA-1)
- Blocks binding of LFA-1 to ICAM-1, inhibiting lymphocyte activation, adhesion to endothelial cells, and migration into psoriatic tissue
Contraindications
- History of severe hypersensitivity to efalizumab or any component of the formulation
- Patients with severe infections, malignancies, or compromised immune systems
- Prior history of progressive multifocal leukoencephalopathy (PML)
Adverse Reactions
- Acute flu-like symptoms (headache, chills, fever, nausea, myalgia) following injections
- Infections (including serious and opportunistic infections)
- Thrombocytopenia
- Worsening or rebound of psoriasis upon discontinuation
- Malignancies (including skin cancers and lymphoproliferative disorders)
Drug Interactions
- Live vaccines: Avoid concurrent administration due to risk of disseminated infection and reduced immunologic response
- Immunosuppressive agents: Increased risk of severe immunosuppression and infection
- Other systemic psoriasis therapies or phototherapy: Increased risk of adverse events and cumulative toxicity
Curated Content: Needs Vetting Before Put to Clinical Use