Transcript Biologics in psoriasis

Biologics in psoriasis
(2008)
Dr. Amal Kokandi
What are biologics?
 "biologics"
are made from human or
animal proteins. Biologics have been
in use for more than 100 years.
Vaccines and insulin are considered
biologics because they are derived
from living sources.
 Approximately 50 biologics are
currently being evaluated for their
efficacy in treating psoriasis (The
Bulletin 2000: 31, 8-9)
Immunology
Amivive (alefacept)
approved in January 2003 by FDA for
treating moderate to severe plaque
psoriasis
 Reduces the number of circulating CD45
RO+ T cells, CD4+ and CD8+ cells
 Given by intramuscular injection in a
doctor's office once per week for 12 weeks
 Additional 12-week treatment cycles might
be necessary or recommended

Enbrel (etanercept)
approved in April 2004 by FDA for treating
moderate to severe plaque psoriasis
 blocks TNF-alpha
 Patients give themselves an injection
under the skin once or twice per week
 Taken continuously to maintain results
 May reduce the progression of joint
damage

Raptiva (efalizumab)
approved in October 2003 by FDA for
treating moderate to severe plaque
psoriasis
 Blocks interaction between LFA-1 and
ICAM-1 (inhibiting T cell activation, cut. T
cell trafficking, T cell adhesion to
keratinocytes and inhibition of CD11A.
 Patients give themselves an injection
under the skin once per week
 Taken continuously to maintain results

Remicade (infliximab)



approved in May 2005 by the U.S. Food and Drug
Administration (FDA) for the treatment of
psoriatic arthritis. It is also approved for treating
rheumatoid arthritis, ulcerative colitis, ankylosing
spondylitis (arthritis affecting the spine) and
Crohn's disease
On Sept. 27, 2006, Remicade was approved for
the treatment of severe plaque psoriasis
Neutralizes soluble TNF-alfa and blocks TNF-alfa
bound to cell membranes
Remicade (infliximab)
 Given
by three separate, two- to
three-hour infusions in a doctor's
office during the first six weeks of
treatment
 Subsequent infusions administered
every eight weeks
 Patients should be screened for
latent (hidden) tuberculosis (TB)
before taking Remicade
Humira (adalimumab)
in October 2005 by the U.S. FDA for the
treatment of psoriatic arthritis. It is also
approved for treating rheumatoid arthritis
 blocks tumor necrosis factor-alpha
(TNFalpha),
 Patients give themselves an injection
under the skin every other week
 Patients should be screened for latent
(hidden) tuberculosis (TB) before taking
Humira

Treatments in phase II for psoriasis
and/or psoriatic arthritis (march 2007)
(17)
 ABT-874,
AS210 (Psoraxine),
Becocalcidiol (Asord), Bimosiamose,
BIRT 2584 XX, BMS-582949, CC10004, CEP-701, Certolizumab pegol
(Cimzia), CH-1504, CNTO 1275,
CTA018, CTAR398, MM-093,
Rambazole, RWJ-445380, and
TGAAC94
Treatments in phase III for psoriasis
and/or psoriatic arthritis (march 2007)
(6)
 Adalimumab
(Humira), BG-12, CNTO
1275, CNTO 148 (golimumab),
Fumaderm, and ISA247