Alemtuzumab in relapsingremitting multiple sclerosis

Abstract

With the anti-CD52 antibody alemtuzumab, the second monoclonal antibody for the treatment of patients with relapsing-remitting multiple sclerosis was approved in Switzerland in December 2014. Alemtuzumab is administered intravenously in two treatment courses, the second being administered twelve months after the first. The clinical study programme of alemtuzumab encompasses three studies comparing the monoclonal antibody with subcutaneous high-dose interferon beta (IFNB)-1a in treatment- naïve and pretreated patients. The antibody proved to reduce significantly the annualised rate of relapse and the rate of sustained accu - mulation of disability compared with IFNB-1a. In addition, the rate of brain atrophy was significantly lower in alemtuzumab-treated patients. The risks identified with the use of alemtuzumab include infusion-associated reactions, infections and antibody-mediated autoimmunity, in particular autoimmune thyroid disorders and immune thrombocytopenia. In clinical practice, the monoclonal antibody will so far be reserved for the treatment of patients with active disease and in cases of treatment failure.