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Published in: BMC Neurology 1/2016

Open Access 01-12-2016 | Research article

Safety and efficacy of daclizumab in relapsing-remitting multiple sclerosis: 3-year results from the SELECTED open-label extension study

Authors: Ralf Gold, Ernst-Wilhelm Radue, Gavin Giovannoni, Krzysztof Selmaj, Eva Havrdova, Dusan Stefoski, Till Sprenger, Xavier Montalban, Stanley Cohan, Kimberly Umans, Steven J. Greenberg, Gulden Ozen, Jacob Elkins

Published in: BMC Neurology | Issue 1/2016

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Abstract

Background

Daclizumab is a humanized monoclonal antibody against CD25 that modulates interleukin 2 signaling. The SELECT TRILOGY of clinical studies (SELECT/SELECTION/SELECTED) evaluated the safety and efficacy of daclizumab in patients with relapsing-remitting multiple sclerosis (RRMS). We report the long-term safety and efficacy of daclizumab 150 mg subcutaneous every 4 weeks in patients with RRMS in the SELECTED open-label extension study.

Methods

An interim intent-to-treat analysis of all enrolled patients was performed in January 2014 for this ongoing study.

Results

The SELECTED study enrolled 90 % of patients who completed SELECTION. In the safety and efficacy analysis (N = 410), median treatment time in SELECTED was 25 months (range, <1–45). Adverse events (AEs) were reported in 76 % of patients, serious AEs (SAEs) excluding MS relapse in 16 %, and treatment discontinuation due to AEs including multiple sclerosis (MS) relapse in 12 %. AEs were primarily of mild to moderate severity, and common AEs (≥10 %), excluding MS relapse, were nasopharyngitis (12 %) and upper respiratory tract infection (12 %). Most commonly reported SAEs (in ≥3 patients), excluding MS relapses, were increased serum hepatic enzymes, pneumonia, ulcerative colitis, and urinary tract infection (<1 % each). Incidences of AE groups of interest include cutaneous events (28 %), cutaneous SAEs (2 %), gastrointestinal SAEs (2 %), hepatic SAEs, (1 %) and malignancies (1 %). The incidence of AEs, SAEs, and treatment-related study discontinuations did not increase over time and no deaths were reported. The adjusted annualized relapse rate (95 % confidence interval (CI)) analyzed at 6-month intervals was 0.15 (0.10–0.22) for weeks 97–120 and 0.15 (0.10–0.21) for weeks 121–144. In year 3, the adjusted mean (95 % CI) number of new/newly enlarging T2 hyperintense lesions was 1.26 (0.93–1.72) and the mean (median) annualized change in brain volume was −0.32 % (−0.34 %).

Conclusions

The AE incidence did not increase with extension of therapy into year 3 in SELECTED; the safety profile was similar to that previously observed. The clinical efficacy of daclizumab was sustained over the 3 years comprising the SELECT TRILOGY, although potential selection bias cannot be excluded.

Trial registration

Clinicaltrials.gov NCT01051349; first registered January 15, 2010.
Appendix
Available only for authorised users
Footnotes
1
Daclizumab HYP, approved as Zinbryta™, has a different form and structure from an earlier form of daclizumab (Zenapax).
 
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Metadata
Title
Safety and efficacy of daclizumab in relapsing-remitting multiple sclerosis: 3-year results from the SELECTED open-label extension study
Authors
Ralf Gold
Ernst-Wilhelm Radue
Gavin Giovannoni
Krzysztof Selmaj
Eva Havrdova
Dusan Stefoski
Till Sprenger
Xavier Montalban
Stanley Cohan
Kimberly Umans
Steven J. Greenberg
Gulden Ozen
Jacob Elkins
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-016-0635-y

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