Gupta Aditya K, Cherman Andréa M
Division of Dermatology, Department of Medicine, Sunnybrook and Women's College Health Sciences Centre (Sunnybrook Site) and the University of Toronto, ON.
J Cutan Med Surg. 2006 Mar-Apr;10(2):57-68. doi: 10.2310/7750.2006.00014.
Efalizumab (anti-CD11a), a targeted, reversible T-cell modulator, is a humanized monoclonal antibody that provides a rapid onset of action of clinical benefit and has been studied up to 36 months, showing continuous control of plaque-type psoriasis. Efalizumab has recently been approved in Canada for this indication.
To examine the efficacy and safety of efalizumab by presenting the latest data in the treatment of psoriasis.
We searched MEDLINE (1966-2005) for randomized, double-blind studies of efalizumab (1 mg/kg for 12 weeks) using the following key words: psoriasis, efalizumab, biologics, and treatment.
It was found that the proportion of patients who achieved Psoriasis Area and Severity Index (PASI) 75 and PASI 50 ranged from 22 to 39% and 52 to 61%, respectively. PASI 75 improvement was achieved in 44% of patients, who continued to receive efalizumab by week 24. Following 36 months of continuous treatment, a PASI 75 response was achieved by 45% (intent-to-treat [ITT] analysis), 59% (maintenance group analysis), and 73% (as-treated analysis). Its safety profile was similar during the 12-week and 36-month treatment periods.
Currently, more than 3,500 patients have received efalizumab in clinical trials. Efalizumab may be an important treatment option for dermatologists seeking to provide a well-tolerated and effective treatment modality for patients with moderate to severe chronic plaque psoriasis.
依法利珠单抗（抗CD11a）是一种靶向性、可逆性T细胞调节剂，是一种人源化单克隆抗体，临床疗效起效迅速，且已进行了长达36个月的研究，显示对斑块型银屑病有持续的控制作用。依法利珠单抗最近在加拿大已获该适应证的批准。
通过展示银屑病治疗的最新数据来检验依法利珠单抗的疗效和安全性。
我们在MEDLINE（1966 - 2005年）中检索了关于依法利珠单抗（1mg/kg，共12周）的随机、双盲研究，使用了以下关键词：银屑病、依法利珠单抗、生物制剂和治疗。
发现达到银屑病面积和严重程度指数（PASI）改善75%和PASI改善50%的患者比例分别为22%至39%和52%至61%。44%的患者在第24周时持续接受依法利珠单抗治疗并实现了PASI改善75%。经过36个月的持续治疗，意向性治疗（ITT）分析显示45%的患者实现了PASI改善75%，维持组分析为59%，实际治疗分析为73%。在12周和36个月的治疗期间，其安全性概况相似。
目前，超过3500名患者在临床试验中接受了依法利珠单抗治疗。对于寻求为中度至重度慢性斑块型银屑病患者提供耐受性良好且有效的治疗方式的皮肤科医生而言，依法利珠单抗可能是一种重要的治疗选择。
