Cyclosporine + alefacept

Cyclosporine + alefacept is a combination of two immunosuppressive agents used primarily in the management of moderate to severe chronic plaque psoriasis, particularly in patients who have not responded adequately to other therapies. Cyclosporine is a calcineurin inhibitor that suppresses T cell activation by inhibiting the phosphatase activity of calcineurin, thereby preventing the transcription of cytokines such as IL-2 that are essential for T cell proliferation and immune response[2][4]. Alefacept is a recombinant fusion protein consisting of the extracellular domain of leukocyte function antigen-3 (LFA-3) fused to the Fc portion of human IgG1; it binds CD2 on T cells, blocking their activation and inducing apoptosis in memory-effector T lymphocytes[3][5][8]. The combination targets different aspects of T cell-mediated inflammation and may be considered for difficult-to-treat cases or when monotherapy has failed.