>> Patient Information and Leaflets

You can download this leaflet by clicking here

Efalizumab

What are the aims of this leaflet?
This leaflet has been written to help you understand more about efalizumab (Raptiva). It tells you what it is, how it works, how it is used to treat skin conditions, and where you can find out more about it.

What is efalizumab and how does it work?
Efalizumab is a drug that has been designed to resemble normal human molecules. It is therefore classed as a “biological” treatment.  It inhibits inflammation and reduces the activity of the immune system (the body's own defence system). It works in a way that is different from the other biological treatments for psoriasis.

Which skin conditions are treated with efalizumab?
Efalizumab is used to treat psoriasis. It is reserved for use in patients with severe psoriasis who cannot take drugs such as methotrexate, ciclosporin, acitretin or phototherapy - see separate British Association of Dermatologists’ leaflets on these drugs and on severe psoriasis - or who have failed to respond to these treatments.

Why have I been selected for treatment with efalizumab?

Dermatologists will use British Association of Dermatologists Guidelines to decide who is and who is not suitable for treatment.  The availability of this treatment is also likely to be restricted by its cost. Like other biological treatments it is much more expensive than regular non-biologic drugs.

How long will I need to take efalizumab before it has an effect?
Efalizumab does not work immediately. You could see results in as little as 4 weeks. After 12 weeks, a significant improvement is seen by up to 60% of patients.

When should I take efalizumab?
Efalizumab is injected under the skin once weekly. It is stored in a refrigerator and reconstituted (dissolved) prior to injection.  A trained nurse or doctor will teach you how to inject yourself. Instructions are also given in the package insert. You will be provided with bins to dispose of syringes and needles safely.

What dose should I take?
The dose is based on your weight and will be calculated by your doctor. You will be told the dose of efalizumab that is right for you, and trained to inject it yourself.

What are the possible side effects of efalizumab?
The most common side effects of efalizumab are headache, chills, fever, nausea, and muscle aches. These usually occur within 48 hours of the first two efalizumab injections, and often decrease after you have used efalizumab for a few weeks.

Patient using efalizumab have an increased risk of getting:

·          Serious infections. Some infections could become serious and in rare cases may be fatal. If you have an infection, tell your dermatologist before you start using efalizumab. If you get an infection that does not go away while taking efalizumab, tell your dermatologist right away.

·          Cancers. Many drugs that decrease the activity of the immune system can increase the risk of getting a cancer. If you have had cancer you should tell your dermatologist before you start on efalizumab. The role of efalizumab in the development of cancer is not known.

·          Low platelet counts (thrombocytopenia). Low platelet counts have occasionally been found during treatment. Platelets help your blood clot. Call your doctor right away if you notice unusual or easy bruising or bleeding. Your doctor will test your platelet counts.

·          Worsening of psoriasis. Some patients (7 per thousand of the patients treated in clinical trials) have had a serious worsening or developed new forms of psoriasis while taking efalizumab, or after stopping treatment. Tell your dermatologist right away if your psoriasis gets worse or if you see any new rashes during or after treatment with efalizumab

How will I be monitored for the side effects of efalizumab treatment?

You should have had a recent chest x-ray, blood checks and examinations before treatment; and blood checks need only be done at 3 months, 6 months, and then every 6 months. Monitoring with regular visits is very important to check your response and look out for side effects.

National Biologicals Register.   Because the treatment is new you will be asked to take part in a national register for this drug. This register will collect information from all patients on biological treatment for psoriasis and will gather valuable information on side effects, benefits and the best use of treatments. If started on treatment, you will receive details of the register scheme and be required to sign a form giving consent to be included in it. Your dermatologist will have to provide details about the results and any side effects you may experience. You will be involved in reporting adverse effects as well as the effects of the treatment on your psoriasis.  You will also be asked about any other medicines you may require to take.

Can I have vaccinations whilst on efalizumab?
 You should not be immunized using any of the 'live' vaccines such as polio, rubella (German measles) and yellow fever. An 'inactivated' polio vaccine can be given instead of the 'live' one and the 'inactivated' version should also be given to people you are in close contact with, such as members of your household.

If you are on efalizumab you should avoid contact with children who have been given the 'live' polio vaccine, for 4-6 weeks after the vaccination.

Does efalizumab affect pregnancy?
It is not known whether efalizumab can harm an unborn baby or pass into breast milk, and it is best to avoid efalizumab in these situations.  Consult your doctor if you become pregnant.

May I drink alcohol while I am taking efalizumab?
There is no known interaction between alcohol and efalizumab. However, remember that too much alcohol can worsen psoriasis and should be avoided.

Can I take other medicines at the same time as efalizumab?
Most medicines are safe to take with efalizumab. However drugs that suppress the immune system, such as steroids, should be avoided.  It is important that your GP or other doctor is aware that you are taking this treatment if any new drug is prescribed. Your GP and dermatologist should be aware of all your medications, including over-the-counter medicines and supplements (including herbal medicines).

Can I sunbathe?

Sunbeds and sunbathing should be avoided to reduce risk of skin cancer.

Where can I find out more about efalizumab?
This information sheet does not list all of the side effects of efalizumab.  If you want to know more about efalizumab, or if you are worried about your treatment, you should speak to your doctor or pharmacist. 

For fuller details, look at the drug information sheet which comes as an insert with your prescription for efalizumab..

The ‘British Association of Dermatologists guidelines for use of biological interventions in psoriasis’ is available in the guidelines section of the BAD website.

The British Skin Foundation fund vital research into all skin diseases.  To find out how you can help, please visit the British Skin Foundation website here.

(While every effort has been made to ensure that the information given in this leaflet is accurate, not every treatment will be suitable or effective for every person. Your own doctor will be able to advise in greater detail)

BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION SERVICE
PRODUCED JUNE 2005