Raptiva (efalizumab) is an immunosuppressive recombinant monoclonal antibody used in adult patients for the treatment of moderate to severe plaque psoriasis. It was approved by the FDA in 2003 and is administered as a once a week injection. Back on October 2008, the FDA updated Raptiva’s labeling to include a warning on the risk of life-threatening infections, including progressive multifocal leukoencephalopathy (PML). PML is a deadly disease of the Central Nervous System that is caused by the reactivation of the polyomavirus JC (JCV) in the presence of profound immunosuppression. This virus attacks the myelin producing cells in the CNS, especially in the white matter. Patients presenting with PML will usually have altered mental status, visual changes, motor deficits as well as other neurological symptoms.
After four reports of PML, of which 3 died, Genetech, Raptiva’s manufacturer, decided to issue a voluntary withdrawal of this drug. They plan to have Raptiva taken completely off the United States market by June 8, 2009.