Patients with moderate to severe plaque psoriasis: one year after the European Medicines Agency recommendation of efalizumab suspension. 
In February 19, 2009, the European Medicines Agency (EMA) had recommended the suspension of the marketing authorization for efalizumab after the occurrence of cases of progressive multifocal leukoencephalopathy.  To explore the efficacy of alternative therapies for psoriasis and the health status of patients who discontinued efalizumab.  An observational study was performed on 101 patients.  After the EMA communication, efalizumab was discontinued in the following 2-3 months.  In agreement with the patients, we decided to either prescribe other treatments or none at all.  After 1 year, 11 patients are still not treated, 63 patients are treated with biologics, and 9 patients are treated with systemic conventional therapies.  In order to prevent rebound or relapse, various approaches are available, including cyclosporine, methotrexate and biologic therapies.  Interestingly, in 11 out of 31 patients who did not receive any systemic drug, psoriasis is still under control, suggesting a long-term effect of efalizumab.