Daclizumab Use in Patients With Pediatric Multiple Sclerosis

Background: Daclizumab, a humanized monoclonal antibody specific for the interleukin 2 receptor alpha 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. Design: Case series. Setting: Two comprehensive pediatric MS centers. Patients: Seven patients with pediatric-onset MS with clinical and magnetic resonance imaging disease activity despite first-line disease-modifying therapy. Intervention: Intravenous daclizumab, 1 mg/kg monthly. Main Outcome Measures: 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. Conclusion: 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.