The added therapeutic efficacy and safety of alefacept in combination with other (systemic) anti‐psoriatics in refractory psoriasis

Abstract

Objective: Alefacept is a biologic treatment for psoriasis, with a selective effect on memory effector T cells. Few data are available on the combination of alefacept with either topical or systemic anti‐psoriatics. We studied the effect of alefacept combination treatment on clinical disease severity scores and on circulating T‐cell subsets. Methods: Twelve patients with moderate‐to‐severe psoriasis were included and treated with alefacept for a period of 12 weeks. Patients were allowed to continue the anti‐psoriatic therapies they used prior to the study. Severity of disease and expression of T‐cell markers CD4, CD8, CD45RA, CD45RO, CD94, CD161, CD25, and CLA were assessed at baseline and after treatment. Results: Seven of 12 included patients used a concomitant systemic therapy: either methotrexate (n = 4), acitretin (n = 2) or cyclosporine (n = 1). PASI reductions in this group after 12 and 24 weeks were 40% and 55%, respectively. Several lymphocyte subsets showed a reduction in circulating numbers. These decreases were independent of the use of an additional systemic psoriasis therapy. Conclusions: The concomitant use of systemic anti‐psoriatic medication in combination with alefacept has a noteworthy impact on efficacy results. No differences in circulating psoriasis‐relevant T‐cell populations between patients with or without an additional systemic treatment were seen.

• Alefacept
• efficacy
• NK receptors
• psoriasis
• safety
• T cell subsets