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Mult Scler. 2016 Aug;22(9):1215-23. doi: 10.1177/1352458515614092. Epub 2015 Oct 29.

Alemtuzumab for multiple sclerosis: Long term follow-up in a multi-centre cohort.

Author information

1
Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, UK/Department of Neurology, University Hospital of Wales, UK.
2
Department of Neurology, University Hospital of Wales, UK.
3
Department of Neurology, Morriston Hospital, UK.
4
Department of Neurology, Southmead Hospital, UK.
5
Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, UK/Department of Neurology, University Hospital of Wales, UK RobertsonNP@cardiff.ac.uk.

Abstract

BACKGROUND:

Alemtuzumab has recently been approved for treatment of relapsing MS, but concerns remain about its use since long-term studies of adverse events remain limited. Furthermore, a clear understanding of its application and durability of effect in clinical practice has yet to evolve.

OBJECTIVES:

To investigate long-term efficacy and safety outcomes in a multicentre cohort of patients treated with alemtuzumab.

METHODS:

Patients treated from 2000 and followed-up at three regional centres were identified. Baseline and prospective data were obtained and validated by clinical record review.

RESULTS:

One hundred patients were identified with a mean follow-up of 6.1 years (range 1-13). Forty patients were retreated with at least one further treatment cycle. Annualized relapse rates fell from 2.1 to 0.2 (p<0.0001) post-treatment and were sustained for up to eight years of follow-up. Mean change in EDSS score was +0.14. Forty-seven patients developed secondary autoimmunity.

CONCLUSION:

Observed reduction in relapse rates reflected those reported in clinical trials, but we were unable to corroborate previous observations of disability reversal. 40% of patients required additional treatment cycles. Autoimmune adverse events were common, occurring at a higher rate than previously reported, but were largely predictable, and could be managed effectively within a rigorous monitoring regime.

KEYWORDS:

Multiple sclerosis; alemtuzumab; autoimmunity

PMID:
26514979
DOI:
10.1177/1352458515614092
[Indexed for MEDLINE]

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