Impaired lymphocyte depletion and elevated antidrug antibodies with alemtuzumab in MS patients

Takeaway

  • Alemtuzumab antidrug antibodies (ADAs) (pre-infusion binding ADA titers >15,000 and/or complete neutralization at >10-fold dilution) may be associated with reduced post-infusion lymphocyte depletion in some patients with multiple sclerosis (MS). Monitoring lymphocyte depletion over repeat infusion cycles may be useful in this setting.

Why this matters

  • Alemtuzumab is an anti-CD52 targeted monoclonal antibody used to deplete lymphocytes in people with MS.

  • Although alemtuzumab is a humanized antibody, it is highly immunogenic and generates both binding and neutralizing ADAs in the clinical setting.

  • In pivotal trials, ADAs were only seen in 0.6% of people treated with alemtuzumab for one infusion cycle and believed to be clinically insignificant.

  • However, pre-dose binding and neutralizing ADAs were later shown to become increasingly prevalent following subsequent treatment cycles and may limit the biological and clinical efficacy of repeat treatments in some patients.

International Medical Press is a global provider of independent medical education. Its mission is to provide healthcare professionals with high-quality, trusted medical information with the aim of helping optimize patient care.

No responsibility is assumed by International Medical Press for any injury and/or damage to persons or property through negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Because of rapid advances in the medical sciences, International Medical Press recommends that independent verification of diagnoses and drug dosages should be made. The opinions expressed do not reflect those of International Medical Press or the sponsor. International Medical Press assumes no liability for any material contained herein.