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Efficacy and safety of alemtuzumab in a real-life cohort of patients with multiple sclerosis

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Abstract

Background

No postmarketing randomised clinical trials are available about alemtuzumab, and real-world data are limited. We aimed to analyse the efficacy and safety of alemtuzumab in a single-centre cohort of patients with relapsing–remitting MS.

Methods

Patients who took alemtuzumab were enrolled. We collected the following data: age, sex, MS history, expanded disability status scale (EDSS), relapses, magnetic resonance imaging (MRI) parameters after alemtuzumab, and adverse events. EDSS scores before alemtuzumab and at the last follow-up were compared by Wilcoxon test. Time to first relapse was analysed after dividing the cohort on the basis of previous treatment.

Results

Ninety patients were enrolled [women 74.4%; naïve 7; mean follow-up 27 months (SD 23)]. The EDSS was reduced from a median of 2.5 (IQR 1.5–4) before alemtuzumab to 2.0 (IQR 1.5–3.5) after (p = 0.025). The time to first relapse was shorter in patients shifting from a second-line therapy (p = 0.011). Over 2 years, 43.7% had no evidence of disease activity. We observed infusion-related reactions in 95.5% patients, including 11.1% with pneumonitis, thyroiditis in 11%, and thrombocytopenia in 3.3%.

Conclusions

We confirmed the clinical and MRI efficacy of alemtuzumab in the clinical setting and the frequency of infusion-related reactions. Compared with that in clinical trials, higher number of patients developed pneumonitis during infusion.

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Authors and Affiliations

  1. Multiple Sclerosis Center, University of Cagliari/ATS Sardegna, Via Is Guadazzonis, 2, 09126, Cagliari, Italy

    Jessica Frau, Giancarlo Coghe, Lorena Lorefice, Giuseppe Fenu, Luigina Musu & Eleonora Cocco

Authors
  1. Jessica Frau
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  2. Giancarlo Coghe
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  3. Lorena Lorefice
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  4. Giuseppe Fenu
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  5. Luigina Musu
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  6. Eleonora Cocco
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Correspondence to Jessica Frau.

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Frau, J., Coghe, G., Lorefice, L. et al. Efficacy and safety of alemtuzumab in a real-life cohort of patients with multiple sclerosis. J Neurol 266, 1405–1411 (2019). https://doi.org/10.1007/s00415-019-09272-6

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  • DOI: https://doi.org/10.1007/s00415-019-09272-6

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