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Treatment of Recalcitrant Plaque Psoriasis with a Humanized Non-depleting Antibody to CD4

1998; Elsevier BV; Volume: 11; Issue: 1 Linguagem: Inglês

10.1006/jaut.1997.0175

1095-9157

H. Bachelez, B. Flageul, Louis Dubertret, Sylvie Fraitag, Rachel Grossman, Nicole Brousse, Dominique Poisson, Robert W. Knowles, Mary C. Wacholtz, Thomas P. Haverty, Lucienne Chatenoud, Jean‐François Bach,

Autoimmune Bullous Skin Diseases

The presence of activated CD4(+) T lymphocytes in psoriatic skin plaques suggests an immune-mediated pathogenesis for the disease. Six patients with recalcitrant plaque psoriasis (PASI>12) received a humanized non-depleting monoclonal antibody to CD4 (ORTHOCLONE OKT(R)cdr4a). The antibody was well tolerated. Four weeks from treatment, the mean decrease in PASI score was 46%. In three patients disease remission was prolonged for up to 6 months and, in one case, up to 1 year post-treatment. In all patients, circulating CD4+ T-cell counts remained normal and peripheral OKTcdr4a-coated CD4+ lymphocytes were detected up to 10 days after antibody infusion. These results point to the relevance of CD4+ lymphocytes in psoriasis. They also emphasize that depletion of CD4+ cells is not mandatory to achieve therapeutic effectiveness.