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Pharmacy and Wellness Review

Abstract

Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system characterized by the deterioration of the myelin sheath, causing axonal damage which leads to debilitating symptoms. Most therapies for the treatment of MS, including daclizumab, primarily target relapsing-remitting multiple sclerosis (RRMS), a form of MS where patients experience periods of exacerbated symptoms as well as intermittent periods of remission. Daclizumab is a humanized monoclonal antibody that is administered as a once monthly subcutaneous injection. The SELECT trilogy of trials have been instrumental in providing safety and efficacy data for daclizumab. The DECIDE study was the first randomized controlled trial to compare daclizumab to another U.S. Food and Drug Administration (FDA) approved therapy for the treatment of RRMS. There is no universal MS treatment guideline that dictates the order in which medications are used; rather, therapy is chosen based on patient-specific factors and disease severity. Daclizumab may be preferred over other agents due to its favorable injection formulation and its duration of action, but contraindications and side effects limit its use. The pharmacist can serve a critical role in ensuring proper patient education and compliance with the Risk Evaluation and Mitigation Strategies (REMS) program in addition to providing resources to assist patients with cost concerns.

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