Intravenous daclizumab for recalcitrant ocular inflammatory disease.

Abstract

BACKGROUND:

To evaluate outcomes of patients with recalcitrant ocular inflammation treated with intravenous daclizumab.

METHODS:

Retrospective case-series. Seventeen patients (33 eyes) with ocular inflammation who had failed several previous systemic immunomodulatory therapies were included in this study. Daclizumab was infused intravenously at a dose of 1 mg per kilogram every 2 weeks. The dose and intervals were adjusted according to control of inflammation off systemic and/or topical corticosteroid therapy. Control of ocular inflammation without corticosteroid therapy was the primary efficacy end point.

RESULTS:

The mean patient age at the commencement of daclizumab therapy was 34.8(range 8-64 years). Three patients were less than 16 years of age at the initiation of therapy. The duration of drug use was 23.6 +/- 15.7 months (range 8-68 months), and the time to control inflammation was 9.8 +/- 11.3 weeks, which was achieved in 15 patients (88.2%). Flare-up rate was 44 per 100 person-years follow-up. Fifteen of 33 eyes (45%) had an improvement in the visual acuity, 13 eyes (39.3%) had stable acuities, and five eyes (15%) had a worsening of their acuities. Two patients (14%) exhibited worsening of ocular inflammation, and were declared as treatment failures. Side effects associated with daclizumab included nausea, fatigue and muscle aches.

CONCLUSION:

Daclizumab is effective in controlling inflammation in patients with stubborn non-infectious ocular inflammation. It has a corticosteroid-sparing effect, can be used as long-term therapy in children and adults, and is capable of inducing durable remission.

• Authors: Pooja Bhat, Rene A Castañeda-Cervantes, Priyanka P Doctor, C Stephen Foster
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 247 Issue 5 Pg. 687-92 (May 2009) ISSN: 1435-702X [Electronic] Germany
• PMID: 19198869 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Glucocorticoids
• Immunoglobulin G
• Immunosuppressive Agents
• Daclizumab

Topics

• Adolescent
• Adult
• Antibodies, Monoclonal (administration & dosage, adverse effects, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Child
• Daclizumab
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Immunoglobulin G (administration & dosage, adverse effects, therapeutic use)
• Immunosuppressive Agents (administration & dosage, adverse effects, therapeutic use)
• Infusions, Intravenous
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Uveitis (drug therapy, physiopathology)
• Visual Acuity (physiology)