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Severe meningo-/encephalitis after daclizumab therapy for multiple sclerosis
Lidia Stork1, Wolfgang Brück1, Phillip von Gottberg2
1Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 19, 2019
Summary
Daclizumab treatment for multiple sclerosis can cause severe meningoencephalitis, a potentially fatal immune reaction. Early recognition and postmarketing surveillance are crucial for patient safety.
Area of Science:
- Neuroimmunology
- Pharmacovigilance
- Autoimmune Diseases
Background:
- Daclizumab, an interleukin-2 receptor antibody, was approved for relapsing multiple sclerosis.
- Its approval was suspended due to severe inflammatory brain disorders.
Purpose of the Study:
- To summarize clinical, laboratory, radiological, and histological findings in patients who developed meningoencephalitis after daclizumab therapy.
Main Methods:
- Retrospective cohort study of seven patients.
- Analysis of clinical, laboratory, radiological, and histological data.
Main Results:
- Patients presented with meningoencephalitis and systemic symptoms, including fever and rash.
- Six patients met criteria for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
- MRI revealed contrast-enhancing lesions and ependymal/meningeal enhancement; histology showed inflammatory infiltrates with eosinophils. High disability and two deaths were observed.
Conclusions:
- Meningoencephalitis and DRESS are potential, lethal side effects of daclizumab therapy.
- These reactions involve a dysregulated immune response.
- Postmarketing drug surveillance is vital for identifying such adverse events.
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