| Manufacturer || Biogen Idec Ltd
| Disease || Multiple Sclerosis
| Indication || Relapsing MS
| Mode of Action || Interleukin-2 blocking antibody (immunotherapy)
| Approval Status || EMA approved (EU); FDA approved (USA); TGA approved (AUS)
| CAS Number || 152923-56-3
| HS Code || 30021091
| Strength || 150mg
Who is daclizumab for?
Daclizumab is indicated for the treatment of adult patients with relapsing forms of multiple sclerosis (MS) 
Daclizumab should be used only in patients who have had an inadequate response to two or more MS drugs and cannot be treated with any other disease modifying therapy 
. Daclizumab has serious safety risks, including liver injury and immune conditions 
Complete information about daclizumab dosage and administration can be found here 
The recommended therapy consists of
- a subcutaneous injection of 150 mg/mL solution in a single-dose pre-filled syringe once a month .
Daclizumab can cause unpredictable and potentially fatal immune-mediated liver injury. Several cases of serious liver injury including immune-mediated hepatitis and fulminant liver injury have been reported 
. Patients should be closely monitored.
Consult your treating doctor for personalised dosing.
What is daclizumab and how does it work?
Daclizumab is a monoclonal antibody (interleukin-2 receptor blocking antibody) indicated for the treatment of adult patients with relapsing forms of multiple sclerosis (MS) 
MS is a chronic, inflammatory, autoimmune disease of the central nervous system that disrupts communication between the brain and other parts of the body.
It is among the most common causes of neurological disability in young adults and occurs more frequently in women than men. For most people with MS, episodes of worsening function (relapses) are initially followed by recovery periods (remissions). Over time, recovery may be incomplete, leading to progressive decline in function and increased disability. Most people experience their first symptoms of MS between the ages of 20 and 40 
In multiple sclerosis, the body’s immune system incorrectly attacks and damages the protective sheath around the nerve cells in the central nervous system (the brain and spinal cord). Daclizumab is a monoclonal antibody that attaches to T cells. These cells form part of the body’s immune system and they are activated by interleukin-2, a signaling protein in the body. By attaching to the T cells, daclizumab blocks interleukin-2, preventing T cells from attacking and damaging nerve cells. Daclizumab may also have other effects that reduce the immune system’s damaging effects on nerve cells 
What is daclizumab's approval status?
Daclizumab was approved by:
- FDA (USA) on May 27, 2016 
- EMA (EU) on July 1, 2016 
- TGA (AUS) on September 22, 2016 
for the treatment of patients with relapsing forms of multiple sclerosis (MS).
The efficacy of daclizumab was investigated in several clinical trials. One trial compared daclizumab and interferon beta-1a in 1,841 participants who were studied for 144 weeks. Patients receiving daclizumab 150 mg every 4 weeks had on average 0.22 relapses over a year compared with 0.39 in those receiving interferon beta-1a 
. Another trial compared daclizumab with placebo and included 412 participants who were treated for 52 weeks. Patients receiving daclizumab had fewer relapses compared to those receiving placebo 
. In a third study involving 600 patients, daclizumab was found to be more effective than placebo at reducing relapses of the condition. Patients receiving daclizumab 150 mg every 4 weeks had on average 0.21 relapses over a year compared with 0.46 in those receiving placebo 
The most common serious side effects of daclizumab are liver damage, and severe skin reactions 
. In clinical trials, 1.7% of patients receiving Zinbryta had a serious liver reaction such as autoimmune hepatitis, hepatitis and jaundice 
. For the full list of restrictions and of all side effects reported with daclizumab, see the package leaflet 
Summary of Product Characteristics [FDA]: Zinbryta (daclizumab), Biogen, May 2016. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/761029s000lbl.pdf
Summary of Product Characteristics [EMA]: Zinbryta (daclizumab), Biogen Idec Ltd, Feb. 2017. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/003862/WC500210598.pdf
FDA News Release: FDA approves Zinbryta to treat multiple sclerosis, 27/05/2016. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm504000.htm
EMA. Human Medicines: Zinbryta (daclizumab), 19/07/2016 (last update: 06/02/2017), cited on 30/08/2016. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/003862/human_med_001987.jsp&mid=WC0b01ac058001d124
MSRA. Zinbryta has been recommended for inclusion in the PBS, 20/12/2016. http://www.msra.org.au/zinbryta-receives-tga-approval-use-relapsing-ms
Summary of Product Characteristics [TGA]: Zinbryta (daclizumab), Biogen Australia Pty Ltd, Sep. 2016. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2016-PI-02547-1&d=2017011216114622483