University of Oulu

Rauma, I., Mustonen, T., Seppä, J.M. et al. Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients. J Neurol 269, 824–835 (2022).

Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

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Author: Rauma, Ilkka1,2,3; Mustonen, Tiina4; Seppä, Juha Matti5;
Organizations: 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
2Department of Neurology, Tampere University Hospital, Tampere, Finland
3Department of Neurology, Seinäjoki Central Hospital, Seinäjoki, Finland
4Neuro Center, Kuopio University Hospital, Kuopio, Finland
5Department of Neurology, Satasairaala, Pori, Finland
6Clinical Neurosciences, Neurology, Helsinki University Hospital and Helsinki University, Helsinki, Finland
7Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
8Department of Neurology, Päijät-Häme Central Hospital, Lahti, Finland
9Department of Neurology, Mikkeli Central Hospital, Mikkeli, Finland
10Medical Research Center, Oulu University Hospital, Oulu, Finland
11Research Unit of Clinical Neuroscience, University of Oulu, Faculty of Medicine, Oulu, Finland
12Department of Neurology, Lapland Central Hospital, Rovaniemi, Finland
13Department of Neurology, North Karelia Central Hospital, Siun Sote, Joensuu, Finland
14Department of Clinical Neurosciences, University of Turku, Turku, Finland
15Department of Neurology, Kymenlaakso Central Hospital, Kotka, Finland
16Department of Neurology, South Karelia Central Hospital, Lappeenranta, Finland
17Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
18Department of Neurology, Kanta-Häme Central Hospital, Hämeenlinna, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
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Language: English
Published: Springer Nature, 2021
Publish Date: 2022-03-14


Background: Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice.

Objectives: To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients.

Methods: In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files.

Results: Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented.

Conclusions: SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.

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Series: Journal of neurology
ISSN: 0340-5354
ISSN-E: 1432-1459
ISSN-L: 0340-5354
Volume: 269
Issue: 2
Pages: 824 - 835
DOI: 10.1007/s00415-021-10664-w
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
317 Pharmacy
Funding: IR disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Orion Research Foundation sr; The Finnish Medical Foundation; The Finnish MS Foundation; and The Hospital District of South Ostrobothnia.
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