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10.03.2018 | Review | Ausgabe 11/2018 Open Access

Journal of Neurology 11/2018

Monitoring and management of autoimmunity in multiple sclerosis patients treated with alemtuzumab: practical recommendations

Zeitschrift:
Journal of Neurology > Ausgabe 11/2018
Autoren:
Virginia Devonshire, Richard Phillips, Hilary Wass, Gerald Da Roza, Peter Senior
Wichtige Hinweise
Please note that the recommendations presented here are not to be used as a replacement for clinical judgment and cannot be used as a legal resource because they do not provide individual guidance in all situations. When considering therapeutic approaches for autoimmunity in alemtuzumab-treated patients, healthcare providers should consider the individual needs, preferences, values, financial situation, and personal context for each patient, in addition to following local labeling guidelines and the risk management plan.

Abstract

Alemtuzumab is a humanized anti-CD52 monoclonal antibody approved in more than 65 countries for the treatment of relapsing–remitting multiple sclerosis (RRMS). Compared with subcutaneous interferon-beta-1a, alemtuzumab significantly reduced clinical disease activity and the rate of brain volume loss, and improved disability outcomes in patients with active RRMS who were either treatment naive (CARE-MS I study) or who had an inadequate response (≥ 1 relapse after ≥ 6 months of treatment) to prior therapy (CARE-MS II study). Adverse events (AEs) associated with alemtuzumab include infusion-associated reactions, infections, and autoimmunity. The most commonly reported autoimmune AEs observed with alemtuzumab involve the thyroid gland, followed by immune thrombocytopenia and nephropathies. A monitoring program was designed and implemented to facilitate the early detection of autoimmune events to ensure timely and adequate management. The aim of this article is to provide physicians (including neurologists, general practitioners, endocrinologists, hematologists, and nephrologists who may be less familiar with the symptoms and treatment of autoimmune events), with practical real-world recommendations for the monitoring and management of autoimmunity associated with alemtuzumab treatment.

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