Long-Term Relief for Selected Patients:
Amevive (Alafacept) is a biologic agent for the treatment of chronic plaque-type psoriasis. It works by destroying the activated white blood cells that enter the skin and cause the psoriasis to erupt. This is a slightly different mechanism that that of Raptiva (Efalizumab) which, rather than destroying these cells, keeps them from entering the skin from blood vessels.
Alafacept's claim to fame is the extremely long remission period that is possible with its use. A course of treatment lasts twelve weeks, after which some patients remain psoriasis-free for the rest of that treatment year.
Who Should Take This Drug?: Adults with moderate to severe chronic plaque-type psoriasis are candidates for this drug. For those in special situations (i.e. anticipated prolonged travel overseas) a course of alafacept may give several months treatment-free clearing. Not having to take along psoriasis creams and injections on a long trip can be quite a plus for these patients.
Which Patients Should Avoid This Drug?: Patients with a history of severe infection (tuberculosis, cancer), or who are HIV-positive should not take alafacept.
How is this Drug Used?: Alafacept is injected once weekly for twelve weeks. Since this is an intramuscular (deep) injection, it is almost always done in the doctor's office. Some patients are able to inject the drug themselves, but it is more difficult than the subcutaneous injections required for other biologics. Every 2 weeks, a blood test called the CD4+ T-cell count must be done. If results are low, a dose has to be skipped. If it stays low, the drug needs to be discontinued.
What are the Side Effects?: Like all currently used biologics, there is a concern about increased risk of infection and malignancy with alafacept. These may be the result of lymphopenia (low white blood cell count) that alafacept is known to cause. Some patients have had liver toxicity with this drug, but alcohol use was a factor in a portion of these cases.
What should you tell your doctor before taking Amevive? Is it OK to miss a dose? Learn more about this drug from About.com's Drug Finder.
