Six-page glossy advertisements for AMEVIVE (alefacept) have become nearly ubiquitous in dermatology journals—including the Archives of Dermatology—since the drug’s approval in early 2003.1 I believe that the ads are problematic.
First, the ads focus on a formulation of AMEVIVE that no longer exists. Only intramuscular (IM) AMEVIVE has been available since October 3, 2003, when poor demand for intravenous (IV) AMEVIVE prompted the manufacturer (Biogen, Inc; now Biogen Idec, Inc [as of November 2003], Cambridge, Mass) to discontinue it.2 Nevertheless, effectiveness data featured in bar graphs prominently displayed on the third page of each ad reflect clinical-trial experience with IV—not IM—AMEVIVE (Figure, A). Data from IV and IM trials are similar, but not identical. In the Figure, compare A with B, which presents bar graphs that I constructed using data from IM trials. (Interestingly, these results were not presented in published reports of the IM AMEVIVE trials3,4; the data were provided on request from Biogen Idec, Inc, where they are “on file.”) With IV AMEVIVE, more patients achieved a 75% or greater reduction on the Psoriasis Area and Severity Index (PASI-75) after 2 courses than after a single course (26% vs 14%)5; with IM AMEVIVE, the percentage of patients achieving PASI-75 after 2 courses was slightly lower than that after a single course (20% vs 21%). Whether these small differences are clinically important is for dermatologists and patients to decide, but they cannot decide if currently relevant data are not presented in the ad.
Katz KA. AMEVIVE’s Advertisements: Problematic?. Arch Dermatol. 2005;141(12):1602–1604. doi:10.1001/archderm.141.12.1602-b