Efalizumab is a humanized antibody to the CD11 subunit of LFA-1 that inhibits the interaction of LFA-1 with its counter-receptors, including ICAM-1. It can interfere with the activation of T lymphocytes, as well as migration of cells from the circulation to sites of inflammation. It has been approved for treatment of psoriasis (Lebwohl et al. 2003). In a 12-week trial of patients with PsA, in which efalizumab was administered subcutaneously once a week, 28% of patients achieved an ACR 20 response versus 19% in the placebo group (p = 0.2717) (Papp et al. 2004). Because there was not statistically significant differentiation between the treatment group and placebo, this agent cannot currently be recommended to control arthritis in a psoriasis patient.
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