Daclizumab use in patients with pediatric multiple sclerosis.
BACKGROUND
Daclizumab, a humanized monoclonal antibody specific for the interleukin 2 receptor α chain, reduces clinical and magnetic resonance imaging disease activity in patients with adult-onset multiple sclerosis (MS) as monotherapy or add-on therapy with interferon.


OBJECTIVE
To report the use of daclizumab in pediatric-onset MS.


METHODS
Case series.


METHODS
Two comprehensive pediatric MS centers.


METHODS
Seven patients with pediatric-onset MS with clinical and magnetic resonance imaging disease activity despite first-line disease-modifying therapy.


METHODS
Intravenous daclizumab, 1 mg/kg monthly.


METHODS
Annualized relapse rates, Expanded Disability Status Scale scores, contrast-enhancing lesions, and adverse effects.


RESULTS
Treatment with daclizumab, primarily combined with interferon, was associated with reductions in annualized relapse rates and contrast-enhancing lesions and with reduction or stabilization of Expanded Disability Status Scale scores in each patient. However, 4 patients had relapses and new contrast-enhancing lesions during daclizumab treatment. No significant adverse effects occurred.


CONCLUSIONS
Daclizumab may be a safe and at least partially effective treatment option for patients with pediatric-onset MS with disease activity despite first-line disease-modifying therapy.
Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, ACC-708, 55 Fruit St, Boston, MA 02114, USA.
Mark P
MP
Gorman
Jan-Mendelt
JM
Tillema
Annika M
AM
Ciliax
Charles R G
CR
Guttmann
Tanuja
T
Chitnis
D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002648:Child; D000077561:Daclizumab; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000097:blood / Q000134:cerebrospinal fluid; D053645:Interleukin-2 Receptor alpha Subunit / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D012189:Retrospective Studies
D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D007376:Interleukin-2; D053645:Interleukin-2 Receptor alpha Subunit; D000077561:Daclizumab