Efalizumab

Efalizumab Brand Name– Raptiva

What is Efalizumab

NOTE: This drug is discontinued in the United States.

Efalizumab is an anti-CD11a monoclonal antibody leading to immunosuppressive effects.

Efalizumab is a humanized IgG₁-kappa isotype monoclonal antibody with a molecular weight of approximately 15 kDa.

Efalizumab is produced in a Chinese hamster ovary mammalian cell expression system in a nutrient medium containing gentamicin; gentamicin is not detectable in the final product.

Efalizumab therapy targets T-cells and prevents their activation without destroying them. In the management of psoriasis, patients treated with efalizumab experience improvement in their disease. Response to therapy may be seen within 14 days.

A rebound or flare reaction has been noted following discontinuation of efalizumab therapy.

A phase II study evaluating the use of efalizumab in patients with rheumatoid arthritis has been conducted and no net clinical benefit was noted.

In August 2002, the brand name of this product was changed from Xanelim to Raptiva.

The FDA approved efalizumab for the treatment of psoriasis on October 24, 2003.

Indications

• psoriasis

For the treatment of patients with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy

Side Effects

1. acne vulgaris
2. angioedema
3. antibody formation
4. arthralgia
5. aseptic meningitis
6. asthenia
7. back pain
8. bronchiolitis obliterans
9. chills
10. dyspnea
11. elevated hepatic enzymes
12. eosinophilia
13. erythema multiforme
14. fever
15. Guillain-Barre syndrome
16. headache
17. hearing loss
18. hemolytic anemia
19. hepatitis
20. infection
21. laryngospasm
22. leukocytosis
23. lymphocytosis
24. maculopapular rash
25. myalgia
26. myelitis
27. nausea
28. new primary malignancy
29. peripheral edema
30. pneumonitis
31. progressive multifocal leukoencephalopathy
32. psoriasis
33. serum sickness
34. sialadenitis
35. thrombocytopenia
36. urticaria
37. vomiting
38. weakness

Monitoring Parameters

• LFTs
• platelet count

Contraindications

• acquired immunodeficiency syndrome (AIDS)
• breast-feeding
• children
• fungal infection
• Guillain-Barre syndrome
• hamster protein hypersensitivity
• hemolytic anemia
• herpes infection
• human immunodeficiency virus (HIV) infection
• immunosuppression
• infection
• leukemia
• lymphoma
• mycobacterial infection
• neoplastic disease
• neurological disease
• peripheral neuropathy
• pregnancy
• progressive multifocal leukoencephalopathy
• psoriasis
• thrombocytopenia
• vaccination
• varicella
• viral infection

Interactions

• Abatacept
• Acetaminophen; Aspirin, ASA; Caffeine
• Alefacept
• Alpha interferons
• Antithymocyte Globulin
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Azathioprine
• Certolizumab pegol
• Cladribine
• Corticosteroids
• Cyclophosphamide
• Cyclosporine
• Diclofenac
• Diclofenac; Misoprostol
• Fludarabine
• Golimumab
• Interferon Alfa-2a
• Interferon Alfa-2b
• Interferon Alfa-2b; Ribavirin
• Interferon Alfa-n3
• Interferon Alfacon-1
• Live Vaccines
• Mercaptopurine, 6-MP
• Methotrexate
• Peginterferon Alfa-2a
• Peginterferon Alfa-2b
• Penicillamine
• Pentostatin
• Purine analogs
• Rilonacept
• Sipuleucel-T
• Temozolomide
• Thioguanine, 6-TG
• Tocilizumab