Journal Article

Alemtuzumab vs. Interferon Beta-1a in Early Multiple Sclerosis

Selmaj, Krzysztof W, Compston, D Alastair S, Tandon, P K, Lake, Stephen L, Moran, Susan, Norris, Kim, Coles, Alasdair J, Margolin, David H

2008

Overview

In this randomized, phase 2 trial involving previously untreated patients with early, relapsing–remitting multiple sclerosis, alemtuzumab, a monoclonal antibody targeting CD52 on lymphocytes and monocytes, was more effective than interferon beta-1a in reducing the progression of disability and relapse. Alemtuzumab caused autoimmune complications, including immune thrombocytopenic purpura (resulting in one death) and thyroid disorders. In this trial involving previously untreated patients with early, relapsing–remitting multiple sclerosis, alemtuzumab, a monoclonal antibody targeting CD52 on lymphocytes and monocytes, was more effective than interferon beta-1a in reducing the progression of disability and relapse. Multiple sclerosis typically follows a relapsing–remitting course, but most patients eventually convert to a secondary progressive phase characterized by deficits that increase in the absence of further relapses. This clinical evolution reflects the complex interplay of focal inflammation, demyelination, and axonal degeneration in the central nervous system. Current disease-modifying treatments decrease the frequency of relapse and modestly reduce the accumulation of disability but have not been shown to prevent secondary progression. 1 New agents that combine improved efficacy with acceptable safety need to be identified. The humanized monoclonal antibody alemtuzumab (Campath-1H; Campath, or MabCampath; Genzyme) targets CD52 on lymphocytes and monocytes. . . .

• Publisher: Massachusetts Medical Society
• Subject: Adjuvants, Immunologic - adverse effects / Adjuvants, Immunologic - therapeutic use / Adolescent / Adult / Alemtuzumab / Antibodies, Monoclonal - adverse effects / Antibodies, Monoclonal - therapeutic use / Antibodies, Monoclonal, Humanized / Antibodies, Neoplasm - adverse effects / Antibodies, Neoplasm - therapeutic use / Autoimmune Diseases - chemically induced / Biological and medical sciences / Drug therapy / Female / General aspects / Humans / Infections - chemically induced / Interferon / Interferon beta-1a / Interferon-beta - adverse effects / Interferon-beta - therapeutic use / Magnetic Resonance Imaging / Male / Medical sciences / Middle Aged / Multiple sclerosis / Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis / Multiple Sclerosis, Relapsing-Remitting - drug therapy / Multiple Sclerosis, Relapsing-Remitting - pathology / Neurology / NMR / Nuclear magnetic resonance / Patients / Purpura, Thrombocytopenic - chemically induced / Purpura, Thrombocytopenic - immunology / Thyroid Diseases - chemically induced / Thyroid Diseases - immunology / Treatment Outcome