Daclizumab
Daclizumab is a monoclonal antibody against the
interleukin-2 receptor that binds to CD-25. It has
been found to decrease abnormal T-cell activation
and may also increase the population of regulatory
natural killer cells. Daclizumab has been administered
by intravenous infusion and, more recently, by
subcutaneous injection. Two phase 2 trials have been
completed that indicate efficacy in relapse reduction
and MRI outcomes (Giovannoni et al., 2011; Wynn
et al., 2010). The SELECT trial was a 1-year, randomized,
double-blind trial that compared 150 and
300 mg of monthly subcutaneous daclizumab to
placebo. Both treatment groups reduced annual relapse
rate by approximately 50% (p = .0002). New and enlarging
T2 MRI lesions were reduced by 70%Y78%
(p G .0001; Giovannoni et al., 2011). A second phase 2
trial, the CHOICE trial, was a 24-week study of
230 patients with RRMS who had at least one relapse
or Gd-enhancing lesion in the brain or spinal cord
while on stable interferon beta therapy. Patients were
randomized to receive high-dose daclizumab (2 mg/kg
every 2 weeks subcutaneously plus interferon beta),
low-dose daclizumab (1 mg/kg every 4 weeks subcutaneously
plus interferon beta), or interferon beta
plus placebo. The primary outcome was new or enhancing
MRI lesions, and a significant 72% reduction
was observed in the number of new or enlarging T2
MRI lesions in the high-dose daclizumab plus interferon
beta group compared with the interferon beta
plus placebo group (p = .004). Adverse events included
rash and infections consisting mainly of urinary
tract and respiratory tract infections (Wynn et al., 2010).
Mild lymphopenia and mild elevations in hepatic enzymes
have also been observed with daclizumab treatment
(Martin, 2012). A phase 3 trial of daclizumab
is currently in progress.
DaclizumabDaclizumab is a monoclonal antibody against theinterleukin-2 receptor that binds to CD-25. It hasbeen found to decrease abnormal T-cell activationand may also increase the population of regulatorynatural killer cells. Daclizumab has been administeredby intravenous infusion and, more recently, bysubcutaneous injection. Two phase 2 trials have beencompleted that indicate efficacy in relapse reductionand MRI outcomes (Giovannoni et al., 2011; Wynnet al., 2010). The SELECT trial was a 1-year, randomized,double-blind trial that compared 150 and300 mg of monthly subcutaneous daclizumab toplacebo. Both treatment groups reduced annual relapserate by approximately 50% (p = .0002). New and enlargingT2 MRI lesions were reduced by 70%Y78%(p G .0001; Giovannoni et al., 2011). A second phase 2trial, the CHOICE trial, was a 24-week study of230 patients with RRMS who had at least one relapseor Gd-enhancing lesion in the brain or spinal cordwhile on stable interferon beta therapy. Patients wererandomized to receive high-dose daclizumab (2 mg/kgevery 2 weeks subcutaneously plus interferon beta),low-dose daclizumab (1 mg/kg every 4 weeks subcutaneouslyplus interferon beta), or interferon betaplus placebo. The primary outcome was new or enhancingMRI lesions, and a significant 72% reductionwas observed in the number of new or enlarging T2MRI lesions in the high-dose daclizumab plus interferonbeta group compared with the interferon betaplus placebo group (p = .004). Adverse events includedrash and infections consisting mainly of urinarytract and respiratory tract infections (Wynn et al., 2010).Mild lymphopenia and mild elevations in hepatic enzymeshave also been observed with daclizumab treatment(Martin, 2012). A phase 3 trial of daclizumabis currently in progress.
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