Daclizumab is effective in people with high disease activity

Daclizumab the dark horse of MS DMTs in late-stage development. #MSBlog #MSResearch

"This paper describes the effect of daclizumab on MSers with highly-active MS. It is reassuring to note that daclizumab is as effective in this subgroup as in MSers with less active disease."

"Daclizumab is the dark horse of the current DMTs in late-stage development. It has a greater impact on decreasing disability progression that what you would expect from its impact on relapses. Therefore it may be having some impact on downstream events similar that what has been observed with laquinimod. This is interesting in that Daclizumab is a antibody therapy that appears to be working via expanding a population of immune cells called natural killer cells or NK cells. NK cells are part of our so called innate immune system and have a role in fighting viral infections. Could the NK cell link be more evidence that MS is due to a virus? Daclizumab also seriously questions the role of CD4  T cells and regulatory cells in MS. Daclizumab works by blocking a type of receptor on T regulatory cells and diverting the growth factor, IL2, that binds to this receptor to other cells types. What is all this immunological information tell us about MS? I think T cell immunologists should take their blinkers off and ask themselves some questions about the biology of daclizumab and what it is telling us about MS."


Epub: Giovannoni et al. Effect of daclizumab high-yield process in patients with highly active relapsing-remitting multiple sclerosis. J Neurol. 2013 Dec.


Background: MSers with highly active relapsing-remitting multiple sclerosis (RRMS) are at greater risk for disease progression and may respond differently to MS therapeutics than those with less active disease.

Objectives: The current post-hoc analysis evaluated the effects of daclizumab high-yield process (DAC HYP) vs. placebo in MSers with highly active RRMS in the SELECT study.

Methods: Highly active RRMS was defined as patients with ≥2 relapses in the year before randomization and ≥1 gadolinium-enhancing (Gd+) lesion at baseline. Because results were similar in the DAC HYP dose groups, data from the DAC HYP arms were pooled for analysis.

Results: Treatment with DAC HYP resulted in similar effects in highly active (n = 88) and less active (n = 506) RRMS MSers. DAC HYP reduced the annualized relapse rate by 50 % and 51 % in the highly active (p = 0.0394) and less active (p < 0.0001) groups vs. placebo, respectively (interaction p = 0.82). DAC HYP reduced new/newly-enlarging T2 lesions (highly active RRMS 76 % reduction, p < 0.0001; less active RRMS 73 % reduction, p < 0.0001; interaction p = 0.18), the risk of having more Gd+ lesions (highly active RRMS 89 % reduction, p < 0.0001; less active RRMS 86 % reduction, p < 0.0001; interaction p = 0.46), and sustained disability progression (highly active RRMS 88 % reduction, p = 0.0574; less active RRMS 46 % reduction, p = 0.0383; interaction p = 0.22) vs. placebo.

Conclusions: DAC HYP efficacy was similar across the spectrum of MS disease activity as assessed prior to treatment initiation.


Daclizumab high-yield process (DAC HYP) is an investigational, once-monthly, subcutaneous therapy antibody reacting to CD25

CoI: This is work by TeamG

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