The Biologic with the Longest Track Record in Plaque Type Psoriasis: With several biologics now on the market and many more in the pipeline, Raptiva (efalizumab) stands out as the one with the largest number of psoriasis patients studied and over a longer period of time than any other biologic.
Who Should Take This Drug?: Raptiva is approved for plaque type psoriasis in patients 18 years and older. It is especially well-suited for patients whose symptoms didn't improve with another biologic, who have severe psoriasis on their hands and feet, or who are overweight.
Which Patients Should Avoid This Drug?: Since efalizumab has little benefit in psoriatic arthritis and may worsen related symptoms, patients with psoriatic arthritis should look to another biologic better suited to their situation.
How is this Drug Used?: The drug is injected once a week at home; dosing is based on weight. Heavier patients find this helpful as other drugs with a "one size fits all" dosing regimen may actually underdose larger patients. The initial dose is always 80% of the full dose to minimize the possibility and severity of any flu-like symptoms which may occur with the first injection. It takes about 12 weeks to see significant improvement with this drug.
What are the Side Effects?: Some patients experience new lesions, new forms of psoriasis, or even different types of rashes early on in treatment. There are some reports of low blood platelets; patients on the drug have platelet counts checked quarterly and for a year after the drug has been discontinued. Like all biologics, Raptiva effects the immune system and there is theoretical concern for a possible increase in malignancies with its use. There are however, no clear cut links between Raptiva and malignancy in the studies done to date.
