About 4.5 million adults in the United States have psoriasis,1 a chronic, often uncomfortable and disfiguring disease
typically lasting more than 30 years. Approximately half a million individuals
find the disease a substantial problem in everyday life. Fewer than half of
those affected by psoriasis find their treatment highly satisfactory.1
Although available treatment options for patients with severe psoriasis
have changed little over nearly 20 years, psoriasis has recently become a
focus for innovative therapies. With the development of monoclonal antibodies
that alter immune function, 4 new products—2 antibodies that modulate
T-cell functions (efalizumab and alefacept) and 2 tumor necrosis factor α
inhibitors (infliximab and etanercept)—have demonstrated beneficial
effects on moderate to severe psoriasis. In this issue of THE JOURNAL, Gordon
et al2 report on the effect of efalizumab on
psoriasis as measured by both physician and patient assessment. This and other
studies demonstrate that efalizumab is superior to placebo.2- 4 To
determine the place of efalizumab in the current therapeutic armamentarium,
however, its safety and efficacy must be determined relative to other therapies
for severe psoriasis.
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