***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND To provide safety data for efalizumab , a recombinant humanized monoclonal IgG(1 ) antibody , in adults with chronic plaque psoriasis . METHODS A 12-week , Phase IIIb , r and omized , double-blind , parallel-group , placebo-controlled trial . At 58 study sites in the USA and Canada , 686 patients with moderate to severe chronic plaque psoriasis received an initial conditioning dose of efalizumab 0.7 mg/kg subcutaneously ( SC ) followed by either 11 weekly doses of efalizumab 1 mg/kg SC or matching placebo . Main outcome measures were safety and tolerability outcomes ( primary ) and efficacy outcomes ( secondary ) . RESULTS During 12 weeks of therapy with efalizumab or placebo , the incidence of clinical adverse events was 82.2 % and 72.9 % , respectively ; the incidence of serious adverse events was 1.8 % and 3.4 % , respectively ; and the incidence of nonserious adverse events leading to withdrawal was 1.8 % and 1.7 % , respectively . In the efalizumab group , there were no clinical ly significant changes in vital signs or laboratory parameters and no evidence of end-organ toxicities . A significantly higher proportion of patients receiving efalizumab than those receiving placebo achieved > or = 75 % improvement in the Psoriasis Area and Severity Index ( PASI ) ( P < 0.001 ) , > or = 50 % improvement in PASI ( P < 0.001 ) , and a static Physician 's Global Assessment rating of Minimal or Clear ( P < 0.001 ) . The mean improvement in the Psoriasis Symptom Assessment was significantly greater in the efalizumab group ( P < 0.001 ) . CONCLUSIONS Efalizumab treatment SC for 12 weeks was safe , well tolerated , and effective in patients with moderate to severe chronic plaque psoriasis The Psoriasis Area and Severity Index ( PASI ) and Physician Global Assessment ( PGA ) are commonly used , but fail to measure quality of life and the patient 's perception of well-being . In response to these limitations , the National Psoriasis Foundation ( NPF ) Medical Advisory Board has developed the NPF Psoriasis Score ( NPF-PS ) . This article evaluates the degree of concordance between NPF-PS , PASI , and PGA scores via an investigator-initiated , single-center , double-blind , placebo-controlled study of thirty-three patients with moderate to severe plaque psoriasis . Our results indicated that NPF-PS was strongly correlated with PASI and PGA in this study , while better reflecting patient perception . This is the first report of a double-blind placebo-controlled study demonstrating this concordance BACKGROUND Interactions between leukocyte-function-associated antigen type 1 ( LFA-1 ) and intercellular adhesion molecules are important in the pathogenesis of psoriasis .  Efalizumab , a humanized monoclonal antibody , binds to the alpha subunit ( CD11a ) of LFA-1 and inhibits the activation of T cells . METHODS In a phase 3 , multicenter , r and omized , placebo-controlled , double-blind study , we assign 597 subjects with psoriasis to receive subcutaneous efalizumab ( 1 or 2 mg per kilogram of body weight per week ) or placebo for 12 weeks . Depending on the response after 12 weeks , subjects received an additional 12 weeks of treatment with efalizumab or placebo . Study treatments were discontinued at week 24 , and subjects were followed for an additional 12 weeks . RESULTS At week 12 , there was an improvement of 75 percent or more in the psoriasis area- and -severity index in 22 percent of the subjects who had received 1 mg of efalizumab per kilogram per week and 28 percent of those who had received 2 mg of efalizumab per kilogram per week , as compared with 5 percent of the subjects in the placebo group ( P<0.001 for both comparisons ) . Efalizumab-treated subjects had greater improvement than those in the placebo group as early as week 4 ( P<0.001 ) . Among the efalizumab-treated subjects who had an improvement of 75 percent or more at week 12 , improvement was maintained through week 24 in 77 percent of those who continued to receive efalizumab , as compared with 20 percent of those who were switched to placebo ( P<0.001 for both comparisons ) . After the discontinuation of efalizumab at week 24 , an improvement of 50 percent or more in the psoriasis area- and -severity index was maintained in approximately 30 percent of subjects during the 12 weeks of follow-up . Efalizumab was well tolerated , and adverse events were generally mild to moderate . CONCLUSIONS Efalizumab therapy result ed in significant improvements in plaque psoriasis in subjects with moderate-to-severe disease . Extending treatment from 12 to 24 weeks result ed in both maintenance and improvement of responses BACKGROUND Previous studies of infliximab in psoriasis have demonstrated rapid improvement with induction therapy and sustained response with regularly administered maintenance therapy . OBJECTIVE The efficacy and safety of continuous ( every-8-week ) and intermittent ( as-needed ) maintenance regimens were compared . METHODS Patients with moderate-to-severe psoriasis ( n = 835 ) were r and omized to induction therapy ( weeks 0 , 2 , and 6 ) with infliximab 3 mg/kg or 5 mg/kg or placebo . Infliximab-treated patients were r and omized again at week 14 to continuous or intermittent maintenance regimens at their induction dose . RESULTS At week 10 , 75.5 % and 70.3 % of patients in the infliximab 5 mg/kg and 3 mg/kg groups , respectively , achieved PASI 75 ; 45.2 % and 37.1 % achieved PASI 90 ( vs 1.9 % [ PASI 75 ] and 0.5 % [ PASI 90 ] for placebo ; P < .001 ) . Through week 50 , PASI responses were better maintained with continuous compared with intermittent therapy within each dose , and with 5 mg/kg compared with 3 mg/kg continuous therapy . LIMITATIONS Longer term ( > 1 year ) maintenance therapy and further study of  infliximab serum concentrations over this period , in both PASI 75 responders and non-responders , would be preferable . CONCLUSIONS Through week 50 , response was best maintained with continuous infliximab therapy . Infliximab was generally well-tolerated in most patients Summary Background Alefacept , human LFA‐3/IgG1 fusion protein , is a novel biological agent currently being developed for the treatment of chronic plaque psoriasis .  Alefacept selectively reduces the memory‐effector T cells that have been implicated in the pathogenesis of the disease ; as a result , alefacept is classified as a therapy that induces remission ( so‐called ‘ remittive ’ therapy ) . In a previously published r and omized , placebo‐controlled phase II study of intravenous alefacept in 229 patients with chronic plaque psoriasis , clinical improvement was observed during dosing as well as in the postdosing follow‐up period BACKGROUND Inflammatory cytokines such as tumor necrosis factor ( TNF ) have been implicated in the pathogenesis of psoriasis . We evaluated the safety and efficacy of etanercept , a TNF antagonist , for the treatment of plaque psoriasis . METHODS In this 24-week , double-blind study , 672 patients underwent r and omization and 652 either received placebo or received etanercept subcutaneously at a low dose ( 25 mg once weekly ) , a medium dose ( 25 mg twice weekly ) , or a high dose ( 50 mg twice weekly ) . After 12 weeks , patients in the placebo group began twice-weekly treatment with 25 mg of etanercept . The primary measure of clinical response was the psoriasis area- and -severity index . RESULTS At week 12 , there was an improvement from base line of 75 percent or more in the psoriasis area- and -severity index in 4 percent of the patients in the placebo group , as compared with 14 percent of those in the low-dose -- etanercept group , 34 percent in the medium-dose -- etanercept group , and 49 percent in the high-dose-etanercept group ( P<0.001 for all three comparisons with the placebo group ) . The clinical responses continued to improve with longer treatment . At week 24 , there was at least a 75 percent improvement in the psoriasis area- and -severity index in 25 percent of the patients in the low-dose group , 44 percent of those in the medium-dose group , and 59 percent in the high-dose group . The responses as measured by improvements in the psoriasis area- and -severity index were paralleled by improvements in global assessment s by physicians and the patients and in quality -of-life measures .  Etanercept was generally well tolerated . CONCLUSIONS The treatment of psoriasis with etanercept led to a significant reduction in the severity of disease over a period of 24 weeks BACKGROUND Recognition of psoriasis as a T-cell-mediated immune disease has led to the development of various therapeutic approaches directed against the pathogenic T cells . Alefacept , a novel and selective biological recombinant protein , binds CD2 on T cells to block T-cell activation and proliferation and interacts with FcgammaRIII receptors on accessory cells to produce selective T-cell apoptosis . OBJECTIVE To demonstrate the efficacy and safety of once-weekly alefacept IM compared with placebo given for 12 weeks to patients with chronic plaque psoriasis . METHODS Multicentre ( 63 sites in Europe , the USA , and Canada ) , r and omized , double-blind , parallel-group study comparing 10 mg and 15 mg of alefacept and placebo administered IM once weekly for 12 weeks . Patients were followed for an additional 12 weeks after cessation of therapy . Patients were eligible for enrollment if they were > or = 18 years of age , had chronic plaque psoriasis for > or = 12 months involving > or = 10 % body surface area , and had CD4 + T-cell counts at or above the lower limit of normal . RESULTS 507 patients were enrolled into three treatment groups , which were well balanced for demographic , baseline disease characteristics , and treatment history . A significantly greater percentage of patients treated with alefacept 15 mg IM achieved > or = 75 % PASI reduction from baseline 2 weeks after the last dose compared with placebo ( 21 % vs. 5 % , P < 0.001 ) ; 12 % of patients treated with alefacept 10 mg IM reached this level of improvement ( P = NS vs. placebo ) . Alefacept was well tolerated , with adverse events similar to that of placebo . CONCLUSIONS Treatment with alefacept 15 mg IM provided highly significant improvements in all measures of psoriasis disease activity compared with placebo . Pharmacodynamic data confirmed that alefacept is a selective biological agent that reduces memory-effector T cells ( CD4+CD45RO+ and CD8+CD45RO+ ) , the source of the pathogenic mediators of psoriasis , while having relatively no effect on naive T-cell population BACKGROUND Alefacept , human lymphocyte function-associated antigen 3/immunoglobulin 1 fusion protein , binds to CD2 molecules on the surface of activated T cells , selectively targeting memory-effector ( CD45RO+ ) T cells , which comprise more than 75 % of T cells in psoriatic plaques . OBJECTIVE To examine the efficacy and tolerability of intramuscular alefacept . DESIGN International , r and omized , double-blind , placebo-controlled , parallel-group trial . PATIENTS A total of 507 patients with chronic plaque psoriasis . INTERVENTION Placebo , 10 mg of alefacept , or 15 mg of alefacept administered once weekly for 12 weeks followed by 12 weeks of observation . MAIN OUTCOME MEASURE Psoriasis Area Severity Index ( PASI ) . RESULTS Alefacept treatment was associated with dose-related significant improvements in PASI from baseline . Throughout the study , a greater percentage of patients in the 15-mg group than in the placebo group achieved a significant reduction in PASI . Of patients in the 15-mg group who achieved at least 75 % PASI reduction 2 weeks after the last dose , 71 % maintained at least 50 % improvement in PASI throughout the 12-week follow-up . There were no opportunistic infections and no cases of disease rebound . CONCLUSION Intramuscular administration of alefacept was a well-tolerated and effective therapy for chronic plaque psoriasis and thus represents a convenient alternative to intravenous dosing BACKGROUND The efficacy and safety of one and two courses of alefacept have been demonstrated in phase 2 and 3 clinical trials , with a course of alefacept defined as 12 weeks of once-weekly treatment followed by 12 weeks of observation . METHODS This r and omized , single-center study compared the safety and efficacy of a st and ar 
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In addition , our results are not generalizable beyond the patients with moderate to severe plaque psoriasis .
CONCLUSION The two assessment tools are substantially redundant and either alone is a sufficient tool for assessing psoriasis severity in patients with moderate to severe disease .
Because the PASI is better vali date d and more detailed , it remains the score of choice for clinical trials , but the simpler PGA may be well suited for community-based outcomes projects