Blood pressure changes during alemtuzumab infusion for multiple sclerosis patients. (5th December 2020)

• Record Type: Journal Article
• Authors: Shosha, Eslam; Casserly, Courtney; Tomkinson, Christine; Morrow, Sarah A.
• Is Part Of: European journal of neurology. Volume 28:Number 4(2021)
• Page Start: 1396
• Page End: 1400
• Publication Date: 2020-12-05
• Subjects: alemtuzumab -- high blood pressure -- intracerebral hemorrhage -- multiple sclerosis; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.14633
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: Blood pressure (BP) changes during alemtuzumab infusions are poorly understood. The aim of this study was to examine BP changes during alemtuzumab infusions in persons with multiple sclerosis (PwMS). Methods: This was a retrospective cohort review of systolic (S) and diastolic (D) BP in PwMS receiving alemtuzumab. Results: Thirty‐one patients were identified; 22 (64.5%) were women. Mean age and disease duration were 35.2 ± 7.1 and 9.2 ± 5.4 years, respectively. There was no history of hypertension or vascular events. Mean baseline SBP was 119.8 ± 15.1 mmHg, 118.8 ± 14.3 mmHg and 106.5 ± 6.1 mmHg whilst mean DBP was 75.3 ± 9.2 mmHg, 74.1 ± 12.4 mmHg and 69.2 ± 4.3 mmHg at doses 1, 6 and 9, respectively. During the first cycle, SBP increased by 19.2 ± 9.4 mmHg, with comparable percentage increases over the five infusions (16%, 22%, 17%, 11%, 13%, respectively). DBP increased by 6.2 ± 3.8 mmHg with similar percentage increases over the five infusions (8.4%, 11.5%, 5.5%, 7%, 3%). For the second cycle, SBP increased by 16.9 ± 3.2 mmHg, with similar increases over the 3 days (12%, 15%, 17%). DBP increased by 5.4 ± 4.2 mmHg (11%, 9%, 12.8%). The third cycle demonstrated increased mean and percentage of SBP and DBP by 8.9 ± 2.3 mmHg (10%, 70%, 11.8%) and 4.2 ± 1.9 mmHg (3%, 2%, 6.5%), respectively. Collectively, for 31 patients, in the first cycle, mean SBP increased from 119.8 ± 15.1 mmHg to 138.8 ± 13 mmHg ( p ˂ 0.001 ), whilst mean DBP increased from 74.5 ± 9.2 mmHg to 79.2 ± 9.1 mmHg ( p = 0.007). Overall, 17 (54.8%) patients had increasing BP by ≥20% and nine (29%) had increasing BP by ≥20 mmHg from baseline. Conclusions: This demonstrates significant increases in BP during alemtuzumab infusions in PwMS. Abstract : This retrospective study examined blood pressure changes in 31 persons with multiple sclerosis receiving alemtuzumab. Mean age was 35 years; mean duration of multiple sclerosis was 9.2 years. None had a history of hypertension or vascular events. Collectively, for 31 patients, in the first cycle, mean systolic blood pressure increased from 119.8 ± 15.1 mmHg to 138.8 ± 13 mmHg ( p < 0.001), whilst mean diastolic blood pressure increased from 74.5 ± 9.2 mmHg to 79.2 ± 9.1 mmHg ( p = 0.007). Overall, 17 (54.8%) patients had increasing blood pressure by ≥20%, and nine (29%) had increasing blood pressure by ≥20 mmHg from baseline.