title: A single-arm, open-label study of alemtuzumab in treatment-refractory patients with multiple sclerosis.
abstract: BACKGROUND
  Alemtuzumab (CD52-specific humanized monoclonal antibody) was found to be an effective therapy for treatment-naive patients with relapsing-remitting multiple sclerosis.
  
  
  OBJECTIVE
  Evaluate alemtuzumab's effects in patients with treatment-refractory relapsing-remitting multiple sclerosis.
  
  
  METHODS
  Forty-five relapsing-remitting multiple sclerosis patients who experienced ≥2 relapses during 2 years prior to the study entry whilst receiving interferon therapy were administered 24 mg i.v. alemtuzumab/day for 5 days at baseline and 3 days 12 months later. Patients received premedication with 1 g i.v. methylprednisolone on days 1-3 at both times.
  
  
  RESULTS
  After 2-year follow-up, the annualized relapse rate was reduced by 94% compared to pre-treatment levels, from 1.6 (2 years prior to treatment) to 0.17 for the 2 years following (P<0.0001). Moreover, 86% of patients showed stable or improved scores on the Expanded Disability Status Scale, and only 1 experienced an increase in disability lasting ≥6 months. The majority (70-88%) showed stable or improved leg, arm and cognitive function as measured by the Multiple Sclerosis Functional Composite. Serious adverse events observed in single patients were transient neutropenia and pneumonia, pulmonary emboli and deep vein thrombosis. Five patients developed clinical thyroid disorders but no opportunistic infections or cases of immune thrombocytopenic purpura were observed.
  
  
  CONCLUSIONS
  Alemtuzumab effectively reduced relapse rates and improved clinical scores in patients with active relapsing-remitting multiple sclerosis not controlled by interferon therapy.
authors: Central Texas Neurology Consultants, PA, Round Rock, TX, USA. foxtexms@gmail.com
authors: E J
authors: EJ
authors: Fox
authors: H C
authors: HC
authors: Sullivan
authors: S K
authors: SK
authors: Gazda
authors: L
authors: L
authors: Mayer
authors: L
authors: L
authors: O'Donnell
authors: K
authors: K
authors: Melia
authors: S L
authors: SL
authors: Lake
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D061067:Antibodies, Monoclonal, Humanized; D000074323:Alemtuzumab; D008775:Methylprednisolone