Daclizumab

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 17.04.2021

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Definition
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Highly selective, recombinant (human-mouse), humanized, IgG1 antibody against the alpha chain (= Tac; = CD 25) of the human IL-2 receptor.

Pharmacodynamics (Effect)
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Highly selective binding of daclizumab antibodies to the alpha chain of interleukin-2 receptors on activated T cells. This inhibits the proliferation of activated T-cells and thus also interleukin-2 controlled inflammatory processes and rejection reactions via T-lymphocytes. In the presence of daclizumab the stimulating effect of IL-2 on lymphocytes is reduced.

Indication
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Approved for the prophylaxis of acute rejection after kidney transplantation in combination with standard therapy including ciclosporin and systemic glucocorticoids.

According to single case reports ( off-label use) well effective in psoriasis vulgaris, pemphigus vulgaris, psoriatic arthritis, graft-versus-host disease, ulcerative colitis, HIV-associated erythrodermia psoriatica.

Dosage and method of use
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Adults/children: 1 mg/kg bw i.v. in 50 ml sterile NaCl 0.9% solution over 15 minutes. The next application and all further applications are reached in intervals of 14 days each until a total of 5 applications are reached.

Undesirable effects
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According to approval studies, overall few side effects compared with placebo. Rare wound healing disorders, pruritus, acne. Side effects more common in children compared to adults: diarrhea (41%), post-operative pain (38%), fever (33%), vomiting (33%), hypertension (28%), pruritus (21%), upper respiratory tract infections (20%) and urinary tract infections (18%).

Contraindication
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Pregnancy and lactation (insufficient data available). Hypersensitivity to the active substance or other ingredients of the preparation.

Preparations
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Zenapax®

Literature
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  1. Cather JC et al (2003) Investigational therapies for psoriasis. J Am Acad Dermatol 49: S133-138
  2. Dichmann S et al (2002) Humanized monoclonal anti-CD25 antibody as a novel therapeutic option in HIV-associated psoriatic erythroderma. J Am Acad Dermatol 47: 635-366
  3. Gottlieb AB et al (2002) Recombinantly engineered human proteins: transforming the treatment of psoriasis. Clin Immunol 105: 105-116
  4. Jacobsohn DA (2002) Novel therapeutics for the treatment of graft-versus-host disease. Expert Opinion Investig Drugs 11: 1271-1280
  5. Lee SJ et al (2004) Effect of up-front daclizumab when combined with steroids for the treatment of acute graft-versus-host disease: results of a randomized trial. Blood 104: 1559-1564
  6. Linden O (2004) Remission of a refractory, anaplastic large-cell lymphoma after treatment with daclizumab. N Engl J Med 351: 1466-1467
  7. Nashan B (2005) Antibody induction therapy in renal transplant patients receiving calcineurin inhibitor immunosuppressive regimens: a comparative review. BioDrugs 19: 39-46
  8. Renkl A et al (2004) A novel therapeutic option in pemphigus vulgaris: humanized monoclonal anti-CD25 antibody. Br J Dermatol 150: 1220-1222
  9. Van Assche G (2003) A pilot study on the use of the humanized anti-interleukin-2 receptor antibody daclizumab in active ulcerative colitis. At J Gastroenterol 98: 369-376

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Last updated on: 17.04.2021