crizanlizumab

Crizanlizumab is a humanized monoclonal antibody that binds P-selectin (CD62P), a molecule involved in the adhesion of white blood cells, platelets, and sickled red blood cells to the endothelium. By blocking P-selectin, crizanlizumab aims to reduce the vascular adhesion that contributes to vaso-occlusive crises in sickle cell disease.

It is marketed under the brand name Adakveo and was developed for the prevention of painful vaso-occlusive crises in people with sickle cell disease. The medication is administered by intravenous infusion, typically over about one hour, every four weeks. It is indicated for reducing the frequency of vaso-occlusive crises in patients with sickle cell disease. The product labeling specifies the approved age range for use, and clinicians tailor treatment to individual patient needs.

Mechanistically, crizanlizumab interferes with the interaction between activated endothelium and circulating cells, thereby limiting the adhesion and occlusion processes that underlie VOCs. This mechanism is distinct from therapies that target hemoglobin polymerization or hemolysis, offering an additional approach to symptom management in sickle cell disease.

Clinical evidence from pivotal trials demonstrated a reduction in the frequency of vaso-occlusive crises in patients treated with crizanlizumab compared with placebo, supporting its use as a preventive therapy. Common adverse events observed in trials include infusion-related reactions and infections; rare hypersensitivity or immunogenic responses can occur. As with other monoclonal antibodies, monitoring for infusion reactions and antibody development is advised.