Contributions
Abstract: EP1531
Type: ePoster
Abstract Category: Therapy - disease modifying - Risk management for disease modifying treatments
Objective: To report a case of pneumonitis as a serious adverse event after the second day of the first course of alemtuzumab treatment for relapsing MS.
Background: Alemtuzumab is a highly effective anti-CD52 monoclonal antibody, which has the potential for adverse events and serious adverse events. In the trials leading to regulatory approval of alemtuzuab for relapsing forms of MS, 6/1217 patients (0.5%) developed pneumonitis of varying severity.
Methods: Case report.
Results: A 35-year-old white man who had previously had relapses in under 6 months on beta interferons, glatiramer acetate, fingolimod and dimethyl fumarate as well as 18 months after initiating natalizumab. He was, therefore, initiated on alemtuzumab and on infusion day 1, it needed to be hated 3 times due to back pain (requiring additional corticosteroids and opiates) that resolved with famotidine. On infusion day 2, he had a cough that he assumed was gastroesophageal reflux. By infusion day 3, his cough had progressed and during the night after infusion, he had a metallic taste in his mouth and had hemoptysis, requiring an emergency department visit and underwent a chest xray, CT chest and CTA chest (but he left against medical advice prior to admission). Instead of receiving alemtuzumab infusions on day 4 and 5, he received intravenous fluids and methylprednisolone. Two to three weeks prior to alemtuzumab infusions he had an upper respiratory infection that lasted for 4 weeks and involved green mucus discharge. After 3 weeks where he felt "crummy" after the infusions, he had > 4 weeks where he felt "terrific," but 4 months post-alemtuzumab, he began to have problems, including heat sensitivity all over his body, fatigue and visual problems (which usually portend a relapse for him) followed by horizontal diplopia. He underwent 3 days of IV methylprednisolone and rapidly improved with no sequelae. He underwent a second course of alemtuzumab (3 days) without complications.
Conclusion: Pneumonitis, while rare, may occur earlier in the course of alemtuzumab treatment than previously suspected.
Disclosure: Dr. Kantor received no financial support for this study but he has received research support and consulting/speaking honoraria from Sanofi Genzyme.
Abstract: EP1531
Type: ePoster
Abstract Category: Therapy - disease modifying - Risk management for disease modifying treatments
Objective: To report a case of pneumonitis as a serious adverse event after the second day of the first course of alemtuzumab treatment for relapsing MS.
Background: Alemtuzumab is a highly effective anti-CD52 monoclonal antibody, which has the potential for adverse events and serious adverse events. In the trials leading to regulatory approval of alemtuzuab for relapsing forms of MS, 6/1217 patients (0.5%) developed pneumonitis of varying severity.
Methods: Case report.
Results: A 35-year-old white man who had previously had relapses in under 6 months on beta interferons, glatiramer acetate, fingolimod and dimethyl fumarate as well as 18 months after initiating natalizumab. He was, therefore, initiated on alemtuzumab and on infusion day 1, it needed to be hated 3 times due to back pain (requiring additional corticosteroids and opiates) that resolved with famotidine. On infusion day 2, he had a cough that he assumed was gastroesophageal reflux. By infusion day 3, his cough had progressed and during the night after infusion, he had a metallic taste in his mouth and had hemoptysis, requiring an emergency department visit and underwent a chest xray, CT chest and CTA chest (but he left against medical advice prior to admission). Instead of receiving alemtuzumab infusions on day 4 and 5, he received intravenous fluids and methylprednisolone. Two to three weeks prior to alemtuzumab infusions he had an upper respiratory infection that lasted for 4 weeks and involved green mucus discharge. After 3 weeks where he felt "crummy" after the infusions, he had > 4 weeks where he felt "terrific," but 4 months post-alemtuzumab, he began to have problems, including heat sensitivity all over his body, fatigue and visual problems (which usually portend a relapse for him) followed by horizontal diplopia. He underwent 3 days of IV methylprednisolone and rapidly improved with no sequelae. He underwent a second course of alemtuzumab (3 days) without complications.
Conclusion: Pneumonitis, while rare, may occur earlier in the course of alemtuzumab treatment than previously suspected.
Disclosure: Dr. Kantor received no financial support for this study but he has received research support and consulting/speaking honoraria from Sanofi Genzyme.