Daclizumab treatment for multiple sclerosis

Multiple sclerosis is a chronic inflammatory and demyelinating disease of the central nervous system and the leading cause of neurologic disability in young adults. Established therapies, such as interferon and glatiramer, have only partial effects, and they offer limited or no effect on the progression of multiple sclerosis. The etiology of multiple sclerosis is unclear; however, the disease is presumed to be a T-cell-mediated autoimmune disease influenced by genetic and environmental factors. Therefore, targeting of lymphocytes may be a promising means of therapy for multiple sclerosis. Daclizumab is a humanized monoclonal antibody approved for use in preventing renal allograft rejection. The agent is under investigation in phase II trials for the treatment of multiple sclerosis and has demonstrated positive clinical outcomes, including decreased relapse rates. Adverse events included urinary tract infections, respiratory tract infections, paresthesias, mild leukopenia, transient elevations in liver enzyme and bilirubin levels, rash, postinfusion reactions (fever), lymphadenopathy, transient thrombocytopenia, and nausea. Daclizumab may be an alternative or add-on therapy when conventional immunomodulators fail or when existing approved therapies cannot be used. Besides ongoing phase II trials, additional phase II or III trials are required to determine the extended benefits of the agent, as well as clinical outcomes.