Long-term daclizumab therapy for the treatment of noninfectious ocular inflammatory disease

• Published in: Canadian journal of ophthalmology Vol. 46; no. 4; pp. 322 - 328
• Main Authors: Wroblewski, Keith, MD, Sen, H. Nida, MD, Yeh, Steven, MD, Faia, Lisa, MD, Li, Zhuging, PhD, Sran, Pushpa, MD, Gangaputra, Sapna, MD, Vitale, Susan, PhD, MHS, Sherry, Patti, BSN, Nussenblatt, Robert, MD, MPH
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-08-2011
• Subjects: Adolescent; Adult; Aged; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Daclizumab; Female; Follow-Up Studies; Humans; Immunoglobulin G - adverse effects; Immunoglobulin G - therapeutic use; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Injections, Intravenous; Injections, Subcutaneous; Internal Medicine; Male; Middle Aged; Ophthalmology; Retrospective Studies; Treatment Outcome; Uveitis, Intermediate - drug therapy; Uveitis, Intermediate - physiopathology; Uveitis, Posterior - drug therapy; Uveitis, Posterior - physiopathology; Visual Acuity - physiology; Vitreous Body - pathology; Young Adult
• ISSN: 0008-4182; 1715-3360
• DOI: 10.1016/j.jcjo.2011.06.008

Abstract Objective Safety and efficacy of daclizumab during an 11-year period. Design Structured, retrospective chart review. Participants Thirty-nine patients. Methods Patients with chronic, noninfectious intermediate and/or posterior uveitis. Results Thirty-nine patients (78 eyes) were treated for a mean of 40.3 months. Visual acuity improved by ≥2 lines in the better eye in 7 patients (18.4%) and worsened by 2 lines in 6 patients (15.8%) with a mean of 2.8 Snellen lines of vision lost per eye. Six eyes with vitreous cell less than grade 2 lost 2 lines of vision and 7 eyes with less than grade 2 vitreous cell improved 2 lines. Mean number of immunosuppressive medications per patient decreased from 1.89 medications/patient to 1.17 medications/patient. The average number of periocular injections per patient was 1.46 (range, 0-9). The mean number of flares was 2.05/patient (range, 0-12), with the rate being 0.62 flares per patient-year. Four patients developed cancer during the course of this study. Mean time to onset of malignancy was 26 months and the mean age in this group was 49 years. Conclusions Daclizumab demonstrated efficacy in the reduction of concomitant immunosuppressive medication, stabilization of visual acuity, and the prevention of uveitic flares in most cases. Dermatologic complications were the most frequently observed adverse event in our series. Four patients developed solid tumor malignancies during this 11-year period.