Highlights
- •We studied effectiveness and safety of alemtuzumab in Kuwaiti multiple sclerosis patients.
- •Alemtuzumab in Kuwaiti RRMS reduce relapse 61.7%, postpone progression in 91.8%, and decreased MRI activity in 67.1%.
- •NEDA was achieved in 80.8% with early initiation of alemtuzumab in Kuwaiti RRMS.
- •AEs as infusion-related reactions secondary autoimmune were frequent among Kuwaiti MS but could be easily managed.
Abstract
Background
Alemtuzumab, a humanized anti-CD52 monoclonal antibody, has been approved as a treatment
in persons with active relapsing–remitting multiple sclerosis (RRMS). Real-world data
in middle east is very limited. We aimed to evaluate the effectiveness and safety
of alemtuzumab in a real-world clinical setting.
Methods
This observational, registry based study assessed persons with multiple sclerosis
(PwMS) who were treated with alemtuzumab and completed at least follow up one year
after second course. Baseline clinical and radiological characteristics within one
year prior to alemtuzumab initiation were collected. The relapse rate, disability
measures, radiological activity and adverse events at last follow-up visits were assessed.
Results
Data of seventy-three persons with multiple sclerosis (MS) was analyzed, of which
53 (72.6%) were females. Mean age and mean disease duration were 34.25 ± 7.62 and
9.23 ± 6.20 years respectively. Alemtuzumab was started in 32 (43.8%) naïve patients due
to highly active disease and in 25 (34.2%) (PwMS) who were on prior therapies and in
16 (22%) patients due to adverse events on prior medications. Mean follow-up period
was 4 ± 1.67 years. In the last follow-up visits, most of our cohort was relapse free
(79.5% vs. 17.8%; p < 0.001) compared to baseline before alemtuzumab treatment while mean EDSS score
was reduced (2.21 ± 2.15 vs. 2.41 ± 1.85; p < 0.059). The proportion of PwMS who had MRI activity (new T2/ Gd-enhancing) lesions
were significantly reduced compared to baseline (15.1% vs. 82.2%; p < 0.001). NEDA-3 was achieved in 57.5% of (PwMS). NEDA-3 was significantly better
in naïve patients (78% versus. 41.5%; p < 0.002) and in patients with disease duration < 5 years, (82.6% v 43.2%; p < 0.002). Several adverse events such as infusion reactions (75.3%), autoimmune thyroiditis
(16.4%) and glomerulonephritis (2.7%) were reported.
Conclusion
The effectiveness and safety profile of alemtuzumab in this cohort were consistent
with data of clinical trials. Early initiation of Alemtuzumab is associated with favorable
outcome.
Keywords
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Article info
Publication history
Published online: April 09, 2023
Accepted:
April 8,
2023
Received in revised form:
March 25,
2023
Received:
November 19,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
