Immune thrombocytopenia in alemtuzumab-treated MS patients: Incidence, detection, and management

Multiple Sclerosis : Clinical and Laboratory Research
Adam CukerAnn Jannsens

Abstract

Alemtuzumab is a highly effective therapy for relapsing-remitting multiple sclerosis (RRMS), and immune thrombocytopenia (ITP) has been identified as a risk. To examine ITP incidence, treatment, and outcomes during the clinical development of alemtuzumab for RRMS and discuss postmarketing experience outside clinical trials. CAMMS223 and Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis (CARE-MS) I and II investigated two annual courses of alemtuzumab 12 mg (or 24 mg in CAMMS223/CARE-MS II) versus subcutaneous interferon beta-1a three times per week. Patients completing core studies could enroll in an extension. Monthly monitoring for ITP continued until 48 months after the last alemtuzumab infusion. Of 1485 alemtuzumab-treated MS patients in the clinical development program, 33 (2.2%) developed ITP (alemtuzumab 12 mg, 24 [2.0%]; alemtuzumab 24 mg, 9 [3.3%]) over median 6.1 years of follow-up after the first infusion; most had a sustained response to first-line ITP therapy with corticosteroids, platelets, and/or intravenous immunoglobulin. All cases occurred within 48 months of the last alemtuzumab infusion. Postmarketing surveillance data suggest that the ITP incidence is not higher in clinical practice than i...Continue Reading

References

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Citations

Apr 17, 2020·Multiple Sclerosis : Clinical and Laboratory Research·Hans-Peter HartungMichael H Barnett
Oct 28, 2019·Neurology and Therapy·Annette F OkaiUNKNOWN CARE-MS I, CARE-MS II, CAMMS03409, and TOPAZ Investigators
Jun 26, 2020·Journal of Neurology·Brian SteingoUNKNOWN CAMMS223, CAMMS03409, and TOPAZ Investigators
Jan 9, 2021·Multiple Sclerosis Journal - Experimental, Translational and Clinical·Dana HorákováUNKNOWN CARE-MS I, CARE-MS II, and CAMMS03409 Investigators
Feb 4, 2021·Pharmaceuticals·Panagiotis GklinosDimitrios Papadopoulos
Mar 30, 2021·Multiple Sclerosis : Clinical and Laboratory Research·Asta TheodorsdottirZsolt Illes
May 27, 2021·Therapeutic Advances in Neurological Disorders·Alasdair J ColesKrzysztof W Selmaj
Aug 12, 2021·Multiple Sclerosis : Clinical and Laboratory Research·Jens KuhleLudwig Kappos

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Clinical Trials Mentioned

NCT00050778
NCT00530348
NCT00548405
NCT00930553

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