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Alefacept: where it stands today

Importance of the field: The use of biologics that target a subset of immune cells in the treatment of immune-mediated ailments is an emerging field. Alefacept is one of the first biologics in the treatment of psoriasis. It selectively reduces CD45RO+ memory T cells and inhibits T-cell activation. Clinical data support its safety and efficacy in a substantial subset of patients with psoriasis. Areas covered in this review: This article reviews the mechanism of action and the pharmacokinetic and pharmacodynamic properties of alefacept. It also presents the available data about its effectiveness, modes of treatment as well as safety and efficacy in the treatment of psoriasis and other immune-based dermatologic disorders. What the reader will gain: An overview of the published data about the clinical and adverse effects of alefacept in the treatment of psoriasis and a myriad of immunologically-based disorders. Take home message: Ongoing literature supports that alefacept is a safe alternative for the treatment of psoriasis. However, it remains the least prescribed medication in this group of drugs, mainly because it is only effective in a small proportion of patients. Nonetheless, its long-lasting effects and tolerability make it an excellent choice for those who do respond.