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Alemtuzumab: A Review of Its Use in Patients with Relapsing Multiple Sclerosis

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Abstract

Alemtuzumab (Lemtrada™) is a humanized therapeutic monoclonal antibody, which has been approved for use in patients with B-cell chronic lymphocytic leukaemia for several years, and has recently become approved in the EU and several other countries for use in adult patients with active relapsing-remitting multiple sclerosis. This article reviews the available pharmacological properties of intravenous infusions of alemtuzumab and its clinical efficacy and tolerability in adult patients with relapsing-remitting multiple sclerosis. Alemtuzumab is an effective treatment for patients with relapsing-remitting multiple sclerosis, and has a generally acceptable tolerability profile. In phase III trials, it was shown to be more effective than a current first-line treatment, subcutaneous interferon beta-1a, in decreasing relapse rate in treatment-naïve and previously treated patients and in decreasing disability progression in previously treated patients. Of note, these results appear to have extended into the long-term follow-up, despite no further treatment. There was an increased risk of autoimmunity and infection associated with alemtuzumab in these trials; while these adverse events were generally mild to moderate, some were severe. Alemtuzumab is a highly convenient treatment, requiring hospital attendance for an intravenous infusion for a handful of days on two consecutive years, with no treatment required in between; however, this convenience is counterbalanced by the need for regular monitoring for the increased risk of autoimmunity. More investigation is required before final conclusions can be drawn on the correct placement of alemtuzumab in multiple sclerosis treatment; however, it is of a certainty a welcome addition to the treatment options for these patients.

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Disclosure

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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  1. Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754, Auckland, New Zealand

    Karly P. Garnock-Jones

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  1. Karly P. Garnock-Jones
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Correspondence to Karly P. Garnock-Jones.

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The manuscript was reviewed by: P. Albrecht, Department of Neurology, EVK Wesel, Wesel, Germany; P.K. Coyle, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York, USA; M.S. Freedman, Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

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Garnock-Jones, K.P. Alemtuzumab: A Review of Its Use in Patients with Relapsing Multiple Sclerosis. Drugs 74, 489–504 (2014). https://doi.org/10.1007/s40265-014-0195-7

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