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Journal of the American Academy of Dermatology
Volume 57, n° 4
pages 707-710 (octobre 2007)
Doi : 10.1016/j.jaad.2007.05.042
Case & Reviews

Efalizumab-associated thrombocytopenia
 

Sarah Grim Hostetler, BA a, , Matthew Zirwas, MD b, , Mark A. Bechtel, MD b
a The Ohio State University College of Medicine, Columbus, Ohio 
b Department of Internal Medicine, Division of Dermatology, The Ohio State University Medical Center, Columbus, Ohio 

Reprint requests: Matthew Zirwas, MD, OSU Dermatology, 4731 Cramblett Hall, 456 W 10th Ave, Columbus, OH 43210.
Abstract

There have been multiple reports of thrombocytopenia associated with efalizumab therapy for the treatment of psoriasis. The current recommendations are to check platelet counts monthly for the first 3 months of efalizumab therapy, then every 3 months for the duration of therapy. We report a case of efalizumab-associated thrombocytopenia that occurred between 10 and 16 weeks after therapy was initiated. Based on our case and a review of the existing reports in the literature, we recommend monthly platelet counts during the first 4 months of therapy, then every 3 months for the duration of therapy. In addition, if the total platelet count drops by 50 × 109 cells/L or more between any two consecutive counts, we recommend monthly platelet counts be resumed until the count stabilizes. Finally, patients should be educated about and assessed for the signs and symptoms of thrombocytopenia before starting efalizumab therapy and at every follow-up visit.

The full text of this article is available in PDF format.

 Funding sources: None.
 Disclosure: Dr Bechtel has been a paid consultant and is on the speakers bureau for Genentech, Amgen, Abbott, Centocor, and Biogen-Idec. Dr Zirwas has been a paid speaker for Genentech and Abbott, has served as a consultant for Amgen and Biogen-Idec, and has received a grant from Amgen. Ms Hostetler has no conflict of interest to disclose.

  Ms Hostetler is a medical student.


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