Abstract
Alemtuzumab is a monoclonal antibody against the CD52 molecule present in immune cells, predominantly lymphocytes. It was registered in 2001 for the treatment of chronic ß-cell lekaemia and recentl was successfully tested in relapsing-remitting multiple sclerosis (MS) versus standard first line treatment (interferon beta-1a s.c.) in both treatment naive and experienced MS patients.
Alemtuzumab has a strong antiinflammatory effect, decreases the number of relapses, slows down disability progression, decreases the number of new and enlarging T2 hyperintense lesions, the number of gadolinium enhancing lesions shown by magnetic resonance imaging and decreases the rate of brain atrophy. Adverse effects include infusion-related reactions, a slightly elevatzed number of infections and possibility of inducing secondary autoimmunity (thyreopathy, trombocytopenia, nephropathy).
For patient's safety, a comprehensive monitoring program has been introduced which is palnned for 4 years after the last alemtuzumab administration. The advantage raised by alemtuzumab is the long-term effect due to the resetting of the immune system.
Alemtuzumad is administered in two yearly courses, and thereafter only if the new disease activity occurs. In many patients, it results in long-term remission of MS.