c.) to placebo for 1 year. DAC HYP reduced the annualized relapse rate by 54% (150 mg, P < 0·0001) or 50% (300 mg, P = 0·0002), respectively, compared to placebo. DAC HYP also reduced the confirmed disability progression in a highly significant manner by 57% (150 mg) and 43% (300 mg). Further, DAC HYP caused a significant reduction of the cumulative number of new gadolinium-enhancing lesions between weeks 6 and 24 (150 mg: 69%; 300 mg: 78%) and the number
of new or newly enlarging T2-hyperintense selleck products lesions after 1 year (150 mg: 70%; 300 mg: 79%) [78]. A Phase III trial (efficacy and safety of DAC-HYP versus IFN-β-1a in patients with RRMS – DECIDE) with about 1500 patients with RRMS is ongoing to compare daclizumab (150 mg every 4 weeks s.c.) to IFN-β-1a (3 × 44 μg/week) for 2 to 3 years with regard to its impact on the annualized relapse rate, the confirmed disability progression and different MRI parameters [74]. To the best of our knowledge, there is currently no clinical trial testing daclizumab in CIDP. Adverse effects: in the CHOICE study, the incidence
of common adverse events was AUY-922 similar in all groups. The most frequent severe adverse events were infections. There were no opportunistic infections or deaths, and all infections resolved with standard therapies. Two patients, both of whom were treated with daclizumab, developed malignant diseases. One patient with a family history of breast cancer developed breast cancer (ductal carcinoma in situ) more than 1 year after her last daclizumab dose. Another patient had pseudomyxoma peritonei, a recurrence of a pre-existing condition [77]. In the SELECT study, adverse events and treatment discontinuations occurred Sucrase in all study groups with similar frequency. However, severe infections, severe skin reactions and pronounced elevations of liver
enzymes (>5 UNL) were more frequent in the DAC HYP group than in the placebo group. One case of death occurred due to a muscular abscess in a patients recovering form a severe skin reaction [78]. This review summarizes the immune mechanisms and common or divergent clinical effects of a range of treatment options for potential use in MS or CIDP (Table 1). IVIG have been shown to exert short- and long-term beneficial effects in CIDP, but are not recommended in MS. Recombinant IFN-β and GA are approved for basic therapy of CIS and RRMS, but there is no evidence of their efficacy in CIDP. Evidence from randomized, controlled trials exists for azathioprine in RRMS but not in CIDP. Dimethyl fumarate (BG-12), teriflunomide and laquinimod represent three orally administered immunomodulatory drugs, either already approved or likely to be approved in the near future for basic therapy of patients with RRMS due to positive results in Phase III clinical trials. However, clinical trials with these drugs in CIDP have not (yet) been initiated.