Patti Francesco, Chisari Clara G, D'Amico Emanuele, Zappia Mario
a Department "GF Ingrassia", Section of Neurosciences, Multiple Sclerosis Center , University of Catania , Catania , Italy.
Expert Opin Drug Metab Toxicol. 2018 Mar;14(3):341-352. doi: 10.1080/17425255.2018.1432594. Epub 2018 Jan 30.
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. Despite the availability of several disease-modifying therapies for relapsing MS, there is a need for highly efficacious targeted therapy with a favorable benefit-risk profile and a high level of treatment adherence. Daclizumab is a humanized monoclonal antibody directed against CD25, the α subunit of the high-affinity interleukin 2 (IL-2) receptor, that reversibly modulates IL-2 signaling. Areas covered: Daclizumab blocks the activation and expansion of autoreactive T cells that plays a role in the immune pathogenesis of MS. As its modulatory effects on the immune system, daclizumab's potential for use in MS was tested extensively showing a high efficacy in reducing relapse rate, disability progression and the number and volume of gadolinium-enhancing lesions on brain magnetic resonance imaging. Moreover, phase II and III trials showed a favorable pharmacokinetic (PK) profile with slow clearance, linear pharmacokinetics at doses above 100 mg and high subcutaneous bioavailability, not influenced by age, sex or other clinical parameters. Expert opinion: Among the new emerging drugs for MS, daclizumab also, thanks to a favorable PK profile, may represent an interesting and promising therapeutic option in the wide MS therapies armamentarium.
多发性硬化症(MS)是一种中枢神经系统的慢性炎性脱髓鞘疾病。尽管有多种用于复发型MS的疾病修饰疗法,但仍需要一种具有良好效益风险比且治疗依从性高的高效靶向疗法。达克珠单抗是一种针对CD25(高亲和力白细胞介素2(IL-2)受体的α亚基)的人源化单克隆抗体,可可逆地调节IL-2信号传导。涵盖领域:达克珠单抗可阻断自身反应性T细胞的活化和扩增,而自身反应性T细胞在MS的免疫发病机制中起作用。鉴于其对免疫系统的调节作用,对达克珠单抗在MS中的应用潜力进行了广泛测试,结果显示其在降低复发率、残疾进展以及脑磁共振成像上钆增强病灶的数量和体积方面具有高效性。此外,II期和III期试验显示出良好的药代动力学(PK)特征,清除缓慢,剂量高于100 mg时具有线性药代动力学,皮下生物利用度高,且不受年龄、性别或其他临床参数的影响。专家观点:在新兴的MS药物中,由于具有良好的PK特征,达克珠单抗在广泛的MS治疗手段中可能是一个有趣且有前景的治疗选择。