Since the summer of last year, a new drug for the treatment of relapsing multiple sclerosis, Zinbryta® (active ingredient Daclizumab), has been on the market. Compared to the market launches of new drugs in recent years, the introduction of this drug was rather unspectacular, although it is an innovative preparation with a new mechanism of action. While many new MS drugs aim to reduce inflammation cells, the monoclonal antibody Daclizumab, which is contained in Zinbryta®, is an antibody that binds to the so-called interleukin (IL)-2 receptor.
T-lymphocytes, or the inflammation cells responsible for inflammatory attacks on the brain, require the messenger substance interleukin (IL-2) for their stimulation and multiplication. Daclizumab now blocks this important mechanism, but also leads to an “excess” of IL2 due to this blockade and therefore stimulates so-called CD56 bright NK cells (NK cell stands for natural killer cell). These cells have regulatory properties and inhibit autoreactive T-lymphocytes. Zinbryta® is therefore an MS drug that successfully intervenes in the network of inflammatory messenger substances.
In light of the already diverse range of other MS drugs, the question arises as to which MS patients will particularly benefit from this new concept and where the new preparation fits in. A look at the study data helps here. A licensing study of Zimbryta (DECIDE) suggests that the new drug is superior to Interferon-beta 1a i.m. (Avonex). It performed significantly better in terms of reducing relapses and MRI activity. Thus, Zinbryta has a similar study situation as Fingolimod (Gilenya), which also showed better efficacy than Interferon beta 1a i.m. (Avonex) in one of its licensing studies.
The drug is therefore an alternative to Fingolimod, which is currently often used when basic therapies (Interferons, Glatiramer acetate, etc.) do not work optimally. It is also interesting in this context that the effect is reversible and the drug only leads to a slight reduction in white blood cells. Therefore, it could be interesting for patients who show too much of a decrease in lymphocytes in peripheral blood under other preparations. A situation that is sometimes observed with the administration of Dimethyl fumarate (Tecfidera).
Moreover, the drug is easy to use – a subcutaneous injection needs to be given every 4 weeks. On the one hand, one can do this oneself, on the other hand, the injection is also quite well tolerated – i.e., it does not cause flu-like side effects.
Of course, this substance also has side effects, which among other things require regular blood count controls. Common side effects are an increase in liver values. In rare cases, this can also lead to significant changes in liver values – hence the regular blood checks. Skin changes are also more common – most commonly eczema, which subsides spontaneously. Less frequently, these skin reactions can be so severe that the preparation must be discontinued.
Overall, however, it can be assumed that this substance provides another effective and safe preparation – and the availability of another drug will lead to the individual needs of MS patients and their expectations of a therapy being better met.
