Chemistry:Efalizumab

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Short description: Pharmaceutical drug
Efalizumab
Monoclonal antibody
TypeWhole antibody
SourceHumanized (from mouse)
TargetCD11a
Clinical data
Trade namesRaptiva
AHFS/Drugs.comMonograph
Routes of
administration
subcutaneous injection
ATC code
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
ChEMBL
Chemical and physical data
Melting point66 °C (151 °F)
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Efalizumab (trade name Raptiva, Genentech, Merck Serono) is a formerly available medication designed to treat autoimmune diseases, originally marketed to treat psoriasis. As implied by the suffix -zumab, it is a recombinant humanized monoclonal antibody administered once weekly by subcutaneous injection. Efalizumab binds to the CD11a[1] subunit of lymphocyte function-associated antigen 1 and acts as an immunosuppressant by inhibiting lymphocyte activation and cell migration out of blood vessels into tissues. Efalizumab was associated with fatal brain infections and was withdrawn from the market in 2009.[2]

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.[3][4] Four cases of PML were reported in plaque psoriasis patients, an incidence of approximately one in 500 treated patients.[2]

Due to the risk of PML, the European Medicines Agency and the FDA recommended suspension from the market in the European Union and the United States, respectively.[5] In April 2009, Genentech Inc. announced a phased voluntary withdrawal of Raptiva from the U.S. market.[2][6]

References

  1. "Efalizumab binding to the LFA-1 alphaL I domain blocks ICAM-1 binding via steric hindrance". Proceedings of the National Academy of Sciences of the United States of America 106 (11): 4349–54. March 2009. doi:10.1073/pnas.0810844106. PMID 19258452. Bibcode2009PNAS..106.4349L. 
  2. 2.0 2.1 2.2 "Progressive multifocal leukoencephalopathy in patients on immunomodulatory therapies". Annual Review of Medicine 61 (1): 35–47. 2010. doi:10.1146/annurev.med.080708.082655. PMID 19719397. https://zenodo.org/record/1235005. 
  3. "Efalizumab FDA Warning". 16 October 2008. http://www.medpagetoday.com/InfectiousDisease/PublicHealth/11358. 
  4. "Monoclonal antibodies and progressive multifocal leukoencephalopathy". mAbs 1 (6): 583–9. 2009. doi:10.4161/mabs.1.6.9884. PMID 20073129. 
  5. "EMEA press release regarding suspension". http://www.emea.europa.eu/humandocs/PDFs/EPAR/raptiva/2085709en.pdf. 
  6. "Genentech Announces Voluntary Withdrawal of Raptiva from the U.S. Market" (Press release). Genentech, Inc. 8 April 2009. Archived from the original on 28 May 2011. Retrieved 9 April 2009.