Daclizumab

Daclizumab Brand Names- Zenapax | ZINBRYTA

What is Daclizumab

Daclizumab was an immunosuppressant previously indicated for the treatment of relapsing forms of multiple sclerosis.

Daclizumab was also historically used for rejection prophylaxis in renal allograft recipients and marketed under the trade name Zenapax, but this product was discontinued from marketing in 2009.

Daclizumab is a humanized monoclonal antibody (IgG1) produced by recombinant DNA technology that binds specifically to the alpha subunit (p55 alpha, CD25, or Tac subunit) of the human high-affinity interleukin (IL)-2 receptor.

During clinical trials, daclizumab produced a 45% relative reduction in annualized relapse rate and a 54% relative reduction in the mean number of new or newly enlarging T2 hyperintense lesions when compared to interferon beta-1a. Daclizumab is associated with hepatotoxicity.

Daclizumab was initially FDA-approved in December 1997. Daclizumab was withdrawn from the worldwide market in March 2018 due to safety concerns.

Eight cases of inflammation of the brain, including inflammatory encephalitis and meningoencephalitis, severe hepatic damage, and other immune-mediated disorders were associated with Zinbryta.

In the U.S., the use of Zinbryta in multiple sclerosis patients was previously limited to patients who did not respond to prior therapies because of safety concerns associated with use

Indications

  • multiple sclerosis

For the treatment of relapsing forms of multiple sclerosis

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. agranulocytosis
  4. anaphylactic shock
  5. anaphylactoid reactions
  6. anemia
  7. antibody formation
  8. colitis
  9. constipation
  10. dehydration
  11. depression
  12. diabetes mellitus
  13. diarrhea
  14. elevated hepatic enzymes
  15. erythema
  16. erythema multiforme
  17. erythema nodosum
  18. exfoliative dermatitis
  19. fever
  20. flatulence
  21. folliculitis
  22. gastritis
  23. glomerulonephritis
  24. hemolytic anemia
  25. hemorrhoids
  26. hepatic failure
  27. hepatitis
  28. hepatotoxicity
  29. hyperglycemia
  30. immune-mediated reactions
  31. infection
  32. influenza
  33. interstitial lung disease
  34. laryngitis
  35. lupus-like symptoms
  36. lymphadenopathy
  37. maculopapular rash
  38. nausea
  39. new primary malignancy
  40. oral ulceration
  41. pancreatitis
  42. pancytopenia
  43. pharyngitis
  44. pruritus
  45. psoriasis
  46. pyrosis (heartburn)
  47. rash
  48. rhinitis
  49. seizures
  50. sialadenitis
  51. suicidal ideation
  52. thrombocytopenia
  53. vasculitis
  54. vesicular rash
  55. vomiting
  56. xerosis

Monitoring Parameters

  • CBC
  • LFTs
  • serum bilirubin

Contraindications

  • breast-feeding
  • children
  • contraception requirements
  • depression
  • eczema
  • fungal infection
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • herpes infection
  • immune-mediated reactions
  • infants
  • infection
  • lymphoma
  • murine protein hypersensitivity
  • neonates
  • neoplastic disease
  • pregnancy
  • psoriasis
  • reproductive risk
  • requires a specialized care setting
  • requires an experienced clinician
  • suicidal ideation
  • vaccination
  • varicella
  • viral infection

Interactions

  • Azathioprine
  • Basiliximab
  • Canakinumab
  • Carboplatin
  • Chlorambucil
  • Cyclosporine
  • Daunorubicin
  • Doxorubicin
  • Echinacea
  • Infliximab
  • Live Vaccines
  • Melphalan
  • Mycophenolate
  • Natalizumab
  • Ocrelizumab
  • Sirolimus
  • Tacrolimus
  • Temozolomide
  • Tocilizumab
  • Upadacitinib
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