NEW YORK (Reuters Health) May 01 - Alefacept, an immunomodulatory biologic agent that targets T cells, is effective in treating scalp psoriasis in adults, according to a report in the April issue of the Journal of the American Academy of Dermatology.
"Alefacept works as well in scalp psoriasis as it does in generalized body psoriasis," Dr. James Krell from Total Skin and Beauty Dermatology Center, Birmingham, Alabama told Reuters Health.
Dr. Krell and colleagues evaluated the safety and efficacy of alefacept in treating scalp psoriasis in 30 adults, all of whom received 16 once-weekly 15-mg intramuscular doses followed by a 12-week rest period. Those who did not achieve clearing received a second course of treatment.
Five patients (16.7%) achieved treatment success at week 6 after the first course of treatment, the authors report, and an additional 5 patients achieved treatment success 6 weeks after the second course of treatment.
A total of 16 patients (8 after each course of treatment) experienced at least a 75% reduction in their scalp psoriasis area and severity index, the researchers note, and 14 patients (7 after each course of treatment) rated themselves as much improved after treatment.
Only 1 patient reported treatment-related adverse events, including nausea, malaise, and gastrointestinal upset, and no patients withdrew from the study or missed doses because of low CD4+ T lymphocyte counts.
"It is always worth keeping alefacept in mind for the right patient when a very safe biologic medication is needed," Dr. Krell concluded. "As in other forms of psoriasis, alefacept is a third-line drug for me. As far as biologics go, I tend to use either an anti-TNF or Raptiva (efalizumab) before alefacept."
J Am Acad Dermatol 2008;58:609-616.
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