What is new in therapy?

Efalizumab in the treatment of psoriasis

Efalizumab is a humanized, monoclonal antibody, which targets CD11a, one of the subunits of leukocyte function-associated antigen-1. Administered subcutaneously once weekly, it decreases the activation of T lymphocytes as a primary or secondary process and interferes with the trafficking of T cells into sites of inflammation. Clinically, improvement in psoriasis can be observed as early as two to four weeks. The percent of patients experiencing a 75% reduction in PASI (PASI-75) was 27%, 44%, 47% at 12 weeks, 24 weeks, and 24 months, respectively. During the trials, the safety profile was highly favorable, with minor headaches and myalgias occurring after the initial doses. Rebound on abrupt discontinuation can be problematic for some patients and avoided by transition to an alternative therapy. Efalizumab appears to be a valuable option for patients requiring long-term control of their psoriasis.

Retinoids: fascinating up-and-coming scenario

Retinoids have been in sharp focus ever since their introduction 30 years ago. They include any drug (s) that bind to retinoid receptors and elicit a biological response. Enormous information on the subject seems to embroil the recent literature. Practically it is impossible to clearly comprehend the undercurrents. The meticulously dispensing text envisages surmounting the perspective reader's predicaments. Accordingly, retinoids and their related facets namely retinoid receptors, classification, mode of action, and the pharmacological diversity have been precisely defined. Commonly used systemic retinoids too have been given a substantial fresh look along with their monitoring. Overall, adverse effects and relative and absolute contraindications have been scrupulously incorporated. Human immuno deficiency virus (HIV) and isoretinoid for acne, in particular, have been highlighted. Micronized isotretinoin formulations have also been taken care so also commonly used topical retinoids. Tretinoin and their newer formulation have also been accounted for along with tretinoin polymer cream. Adapalene, a new chemical entity possessing a unique physico-chemical activity similar to that of tretinoin has also been dealt with. Newer retinoids are likely to be a subject of intrigue. A focus on future potentials of retinoids is its special ingredient. The inclusion of details of rexinoid the most recent introduction in their purview is likely to invoke interest to further consolidate its reckoning in future. All in all the text of the paper should provide an insight into the current rumbling around retinoids.