ALEMTUZUMAB: LONG TERM FOLLOW-UP IN A SINGLE CENTRE COHORT. Issue 10 (9th September 2014)

• Record Type: Journal Article
• Authors: Willis, Mark; Harding, Katharine; Wardle, Mark; Pickersgill, Trevor; Tomassini, Valentina; Robertson, Neil
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 85:Issue 10(2014)
• Page Start: e4
• Page End: e4
• Publication Date: 2014-09-09
• Subjects: EPILEPSY; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2014-309236.8
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Introduction: Alemtuzumab is an anti-CD52 monoclonal antibody, approved for the treatment of relapsing multiple sclerosis (RMS). However, it has significant side effects and long-term follow-up is required to provide accurate information for patient management and counselling. Methods: Patients were followed prospectively within an active surveillance program and standardised data collected on a regional database. Data on patient demographics, adverse events, disability trajectories (EDSS), relapses and retreatment intervals were analysed. Results: 96 patients with highly active RMS were identified (69F:27M). Mean follow-up post treatment was 5.1 years. Most patients received 2 annual cycles but 27 (28.1%) received 3, 7(7.3%) received 4 and 2 (2.1%) received 5. Pre- and post-treatment annualised relapse rates were 2.1 and 0.4 respectively. Mean change in EDSS from baseline was 0.44. 8 patients developed secondary progression a mean of 2.8 years post treatment. A range of autoimmune disorders (AID), notably thyroid disease was identified in 45 (47%). Discussion: Our data supports the effectiveness of alemtuzumab in patients with RMS in reducing relapse rates. However, despite a paucity of inflammatory disease activity, disability accumulation continued in some patients. Overall retreatment rate was 37.5% and AID, whilst common, could be effectively identified through routine surveillance processes and managed without serious consequence.