DrugMechanism of actionDosageCommon side effectsMonitoringCost*
Alefacept (Amevive)Interferes with the function of antigen-presenting cells7.5 mg IV per week for 12 weeks or 15 mg IM per week for 12 weeks; repeat cycle may be given 12 weeks after first cycle completeLymphopenia, injection-site reactions, influenza-like symptoms, pruritusCheck CD4+ cell count at baseline and weekly thereafter.$8,400 to $11,940 for a 12-week cycle
Efalizumab (Raptiva)Inhibits T-cell/endothelial cell adhesionInitial dose: 0.7 mg per kg SCInfluenza-like symptoms, URI, acne, psoriasis exacerbation; rare but serious side effect is thrombocytopeniaMonitor platelet counts every month initially, then every three months.$18,720 for one year of continuous treatment
1 mg per kg SC per week continuously thereafter
Maximum: 200 mg per dose
Etanercept (Enbrel)Blocks the proinflammatory cytokine TNF-α50 mg SC twice per week for three months, then decrease to maintenance dosage of 50 mg SC per weekInjection-site reactions, URI symptoms, abdominal pain; potential risk of reactivating TBCheck PPD before treatment.$20,700 (60 doses) for one year of continuous treatment
Infliximab (Remicade)Blocks the proinflammatory cytokine TNF-α3 to 10 mg per kg IV infusions (over two hours) at weeks zero, 2, 6, and 14Infusion reactions, URI, pruritus, headache, sore throat; potential risk of reactivating TBCheck PPD before treatment.$22,112 per year, based on eight treatments