{{Short description|Pharmaceutical drug}} {{Use dmy dates|date=December 2023}} {{cs1 config |name-list-style=vanc |display-authors=6}} {{Infobox drug | Verifiedfields = changed | verifiedrevid = 461092863 | type = mab
<!-- Monoclonal antibody data --> | mab_type = mab | source = zu/o | target = CD11a
<!-- Clinical data --> | pronounce = | tradename = Raptiva | Drugs.com = {{drugs.com|monograph|efalizumab}} | MedlinePlus = | DailyMedID = <!-- DailyMed may use generic or brand name (generic name preferred) --> | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> | pregnancy_AU_comment = | pregnancy_category = | routes_of_administration = Subcutaneous | class = | ATCvet = | ATC_prefix = L04 | ATC_suffix = AG02 | ATC_supplemental = | biosimilars =
<!-- Legal status --> | legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled --> | legal_AU_comment = | legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F --> | legal_BR_comment = | legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII --> | legal_CA_comment = | legal_DE = <!-- Anlage I, II, III or Unscheduled --> | legal_DE_comment = | legal_NZ = <!-- Class A, B, C --> | legal_NZ_comment = | legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM / Class A, B, C --> | legal_UK_comment = | legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> | legal_US_comment = | legal_EU = | legal_EU_comment = | legal_UN = <!-- N I, II, III, IV / P I, II, III, IV --> | legal_UN_comment = | legal_status = <!-- For countries not listed above -->
<!-- Pharmacokinetic data --> | bioavailability = | protein_bound = | metabolism = | metabolites = | onset = | elimination_half-life = | duration_of_action = | excretion =
<!-- Identifiers --> | CAS_number_Ref = {{cascite|correct|??}} | CAS_number = 214745-43-4 | CAS_supplemental = | PubChem = | IUPHAR_ligand = | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank = DB00095 | ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} | ChemSpiderID = none | UNII_Ref = {{fdacite|correct|FDA}} | UNII = XX2MN88N5D | KEGG = | ChEBI = | ChEMBL_Ref = {{ebicite|changed|EBI}} | ChEMBL = 1201575 | NIAID_ChemDB = | PDB_ligand = | synonyms =
<!-- Chemical and physical data --> | melting_point = 66 }} '''Efalizumab''' (brand name '''Raptiva)''' is a formerly available medication designed to treat autoimmune diseases, originally marketed to treat psoriasis. It is a recombinant humanized monoclonal antibody administered once weekly by subcutaneous injection. Efalizumab binds to the CD11a<ref>{{cite journal | vauthors = Li S, Wang H, Peng B, Zhang M, Zhang D, Hou S, Guo Y, Ding J | title = Efalizumab binding to the LFA-1 alphaL I domain blocks ICAM-1 binding via steric hindrance | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 106 | issue = 11 | pages = 4349–54 | date = March 2009 | pmid = 19258452 | pmc = 2657446 | doi = 10.1073/pnas.0810844106 | bibcode = 2009PNAS..106.4349L | doi-access = free }}</ref> 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.<ref name=Major/>
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.<ref name="urlEfalizumab FDA Warning">{{cite web|url=http://www.medpagetoday.com/InfectiousDisease/PublicHealth/11358|title=Efalizumab FDA Warning|date=16 October 2008|access-date=7 December 2008}}</ref><ref>{{cite journal | vauthors = Berger JR, Houff SA, Major EO | title = Monoclonal antibodies and progressive multifocal leukoencephalopathy | journal = mAbs | volume = 1 | issue = 6 | pages = 583–9 | year = 2009 | pmid = 20073129 | pmc = 2791316 | doi = 10.4161/mabs.1.6.9884 }}</ref> Four cases of PML were reported in plaque psoriasis patients, an incidence of approximately one in 500 treated patients.<ref name=Major>{{cite journal | vauthors = Major EO | title = Progressive multifocal leukoencephalopathy in patients on immunomodulatory therapies | journal = Annual Review of Medicine | volume = 61 | issue = 1 | pages = 35–47 | year = 2010 | pmid = 19719397 | doi = 10.1146/annurev.med.080708.082655 | url = https://zenodo.org/record/1235005 }}</ref>
Due to the risk of PML, the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) recommend suspension from the market in the European Union and the United States, respectively.<ref name="urlEMEA suspension press release">{{cite web | url = http://www.emea.europa.eu/humandocs/PDFs/EPAR/raptiva/2085709en.pdf | title = EMEA press release regarding suspension | access-date=20 February 2009 | url-status = dead | archive-url = https://web.archive.org/web/20091226101218/http://www.emea.europa.eu/humandocs/PDFs/EPAR/raptiva/2085709en.pdf | archive-date=26 December 2009 }}</ref> In April 2009, Genentech Inc. announced a phased voluntary withdrawal of efalizumabhe U.S. market.<ref name=Major/><ref>{{cite press release | title = Genentech Announces Voluntary Withdrawal of Raptiva from the U.S. Market | publisher = Genentech, Inc. | date = 8 April 2009 | url = https://www.drugs.com/news/genentech-announces-voluntary-raptiva-u-s-market-17125.html | access-date = 9 April 2009 | archive-url = https://web.archive.org/web/20110528052448/http://www.drugs.com/news/genentech-announces-voluntary-raptiva-u-s-market-17125.html | archive-date = 28 May 2011 | url-status = dead }}</ref>
== References == {{Reflist}}
{{Immunosuppressants}} {{Monoclonals for immune system}} {{Merck Serono|state=autocollapse}} {{Portal bar | Medicine}} {{Authority control}}
Category:Recombinant proteins Category:Immunosuppressants Category:Withdrawn drugs Category:Drugs developed by Merck Category:Drugs developed by Hoffmann-La Roche Category:Drugs developed by Genentech Category:Monoclonal antibodies
{{monoclonal-antibody-stub}} {{antineoplastic-drug-stub}}