Safety and Efficacy of Alefacept, Efalizumab, Etanercept, and Infliximab in Treating Moderate to Severe Psoriasis: A Meta-Analysis of Randomized Controlled Trials

Brimhall, Angela K., Master of Science, Clinical Research and Academic Medicine, May 19, 2007, Safety and Efficacy of Alefacept, Efalizumab, Etanercept, and Infliximab in Treating Moderate to Severe Plaque Psoriasis: A Meta-Analysis of Randomized Controlled Trials. Pages=41, Tables=3, Figures=9, Bibliography=61 titles. To evaluate and compare efficacy and safety of biological agents in the treatment of plaque psoriasis, data was identified through four parallel systematic reviews. Randomized, controlled, double-blind, monotherapy trials of alefacept, efalizumab, etanercept and infliximab were selected. Sixteen studies comprising 7,931 patients met inclusion criteria. Efficacy was measured by pooled relative risk (RR) and number needed to treat (NNT) of PASI 75 achievement as compared to placebo. Each biological agent was efficacious (P [less than] .001); however, there was a graded response for achievement of PASI 75. The risk of one or more adverse event was increased in the alefacept, efalizumab, and infliximab groups compared to placebo.