alefacept + methotrexate

Alefacept + methotrexate is a combination therapy used primarily for the treatment of psoriatic arthritis and has also been reported in refractory cases of palmar psoriasis. Alefacept is an immunomodulatory biologic agent that inhibits T-cell activation by binding to CD2 on memory-effector T lymphocytes, thereby reducing their number and activity. Methotrexate is a small molecule antimetabolite that inhibits dihydrofolate reductase, leading to suppression of DNA synthesis and immunosuppressive effects. The combination has demonstrated improved efficacy over methotrexate alone in clinical trials, with significant improvements in joint symptoms (ACR20 response) and skin involvement (PASI50 response). Most adverse events are mild to moderate, with low incidence of serious adverse events or opportunistic infections[1][2][4][5].