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

M D Willis, K E Harding, T P Pickersgill, M Wardle, O R Pearson, N J Scolding, J Smee, N P Robertson

Research output: Contribution to journalArticle (Academic Journal)

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.

Original languageEnglish
Pages (from-to)1215-23
Number of pages9
JournalMultiple Sclerosis Journal
Volume22
Issue number9
Early online date29 Oct 2015
DOIs
Publication statusPublished - Aug 2016

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