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Efalizumab ?
Monoclonal antibody
Type whole antibody
Source humanized (from mouse)
Target CD11a
Identifiers
CAS number 214745-43-4
ATC code L04AA21
DrugBank BTD00074
Chemical data
Formula  ?
Therapeutic considerations
Pregnancy cat.  ?
Legal status

Efalizumab (trade name Raptiva, Genentech, Merck Serono) is a medication designed to treat psoriasis. As implied by the suffix -zumab, it is a recombinant humanized monoclonal antibody. Efalizumab binds to the CD11a subunit of lymphocyte function-associated antigen 1 and acts as an immunosuppressant. It is administered once weekly by subcutaneous injection. It acts to inhibit white blood cell migration out of blood vessels into tissues. Possibly because of immune system suppression, Efalizumab has been associated in some cases with fatal brain infections and has been withdrawn from the market.[1]

Known side effects include bacterial sepsis, viral meningitis, invasive fungal disease and progressive multifocal leukoencephalopathy (PML), a brain infection caused by reactivation of latent JC virus infection.[2][3] Four cases of PML were reported in plaque psoriasis patients, an incidence of approximately one in 500 treated patients.[1]

Due to the risk of PML, the European Medicines Agency and the FDA recommended withdrawal from the market in the European Union and the United States, respectively.[4] In April, 2009, Genentech Inc. announced a phased voluntary withdrawal of Raptiva from the U.S. market.[5][1]

References

  1. ^ a b c Major, E. (2010). "Progressive multifocal leukoencephalopathy in patients on immunomodulatory therapies". Annual review of medicine 61: 35–47. doi:10.1146/annurev.med.080708.082655. PMID 19719397.  edit
  2. ^ "Efalizumab FDA Warning". http://www.medpagetoday.com/InfectiousDisease/PublicHealth/11358. Retrieved 2008-12-07. 
  3. ^ Berger, JR; Houff, SA; Major, EO (2009). "Monoclonal antibodies and progressive multifocal leukoencephalopathy". MAbs 1 (6): 583–9. PMID 20073129.  edit
  4. ^ "EMEA press release regarding suspension" (PDF). http://www.emea.europa.eu/humandocs/PDFs/EPAR/raptiva/2085709en.pdf. Retrieved 2009-02-20. 
  5. ^ Genentech, Inc. (2009-04-08). "Genentech Announces Voluntary Withdrawal of Raptiva from the U.S. Market". Press release. http://www.drugs.com/news/genentech-announces-voluntary-raptiva-u-s-market-17125.html. Retrieved April 9, 2009. 

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