Successful Treatment of Severe Atopic Dermatitis in a Child and an Adult With the T-Cell Modulator Efalizumab

Weinberg, Jeffrey M

doi:10.1001/archderm.142.5.555

Cited by 44 publications

(25 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9 Three cases reports also demonstrated improvement of atopic dermatitis with efalizumab. [12][13][14] The antitumor necrosis factor-alpha agents have been less successful. 15,16 An open-label study of infliximab for atopic dermatitis initially revealed a significant clinical response, but this was not sustained with continued treatment 16 and 2 patients treated with etanercept showed no improvement.…”

Section: Discussionmentioning

confidence: 99%

Alefacept for moderate to severe atopic dermatitis: A pilot study in adults

Moul¹,

Routhouska²,

Robinson³

et al. 2008

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Alefacept for moderate to severe atopic dermatitis: A pilot study in adults

Moul¹,

Routhouska²,

Robinson³

et al. 2008

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

“…This allowed the prediction that CD11a-targeting treatment modalities like the antipsoriatic efalizumab might be also of therapeutic efficacy in atopic dermatitis [14] . And indeed, this MELC methodology-based prediction has very recently been confirmed by some clinical studies demonstrating the positive effects of efa lizumab in atopic dermatitis [24][25][26] , although they still need to be validated under placebo-controlled conditions. Although under our given study conditions we had the opportunity to investigate only a relatively small cohort of patients, we observed 5/6 psoriasis patients in our series as responders to 12 weeks of efalizumab treatment.…”

Section: Additional Datamentioning

confidence: 80%

Topo-Proteomic in situ Analysis of Psoriatic Plaque under Efalizumab Treatment

Bonnekoh

Pommer²,

Böckelmann

et al. 2007

Skin Pharmacol Physiol

View full text Add to dashboard Cite

In a pilot study 6 psoriasis patients were treated over 12 weeks with efalizumab targeting the CD11a subunit of LFA-1. The treatment was well tolerated. Five of these patients proved to be responders with an average decrease in psoriasis area and severity index (PASI) from 21.3 ± 5.4 (day 0) to 3.9 ± 0.6 (week 12). The nonresponder was subsequently successfully treated with cyclosporin. Skin biopsies were taken before and after efalizumab treatment and subjected to Multi-Epitope Ligand Cartography (MELC) robot microscopy. A MELC library of 46 antibodies including FITC-labeled efalizumab was chosen focusing upon inflammatory epitopes. Quantification of marker expression was performed using a special adaptation to the needs of skin tissue in terms of pixel events normalized to a standardized horizontal skin width of 100 µm. The before-versus-after comparison for the responders revealed at the ‘single epitope level’ of MELC analysis a significant decrease (p < 0.05) in epidermal thickness (represented by pan-cytokeratin, CD71, CD138), of the expression of common leukocyte antigen (CD45), T-cell markers (CD2, CD4, CD8, CD45R0), CD11a, efalizumab binding site (EfaBS), and CD58. At the ‘EfaBS-centered, double colocation level’ a corresponding decrease was observed for CD2, CD3, CD4, CD8, CD11a, CD13, CD26, CD44, CD45, CD45R0, CD54, CD62L, HLA-DR, and TIA-1. MELC analysis at the ‘multicombinatorial level’ revealed predominant combinatorial molecular phenotype (CMP) motifs, which showed an efalizumab treatment-dependent significant decrease. These CMP motifs were defined as toponomic combinations of lead markers for (i) leukocytes in general (CD45), (ii) T cells (CD2, CD3, CD4, CD45R0, CD45RA), (iii) macrophages (CD68), (iv) cell activation (CD13, CD26, HLA-DR), and (v) cell adhesion (CD11a, EfaBS). Thirty-five of the most relevant 50 CMP motifs were directly related to the T-cell type. A descriptive statistical analysis of the nonresponder before treatment showed a below-responder range degree of expression for CD4, CD8, CD44 (H-CAM), CD56, CD62L, HLA-DQ, and also for these epitopes in colocation with EfaBS. In the nonresponder and before treatment we observed an above-responder range degree of expression for CD54 (ICAM-1) as LFA-1 ligand. In conclusion, the topo-proteomic data provide new diversified insights into the pleiotropic cellular dynamics in psoriatic skin lesions under effective efalizumab treatment. Moreover, the data may be relevant to the future development of possible strategies for individual prediction of efalizumab treatment response or nonresponse.

show abstract

“…One case report has been published of two patients with severe recalcitrant atopic dermatitis who were successfully treated with efalizumab. 306 Dermatomyositis. One report of a patient with idiopathic DM that had been refractory to 8 weeks of treatment with prednisolone and methotrexate has been published.…”

Section: Efalizumabmentioning

confidence: 99%