Contributions
Abstract: EP1749
Type: ePoster
Abstract Category: Therapy - disease modifying - 29 Risk management for disease modifying treatments
Background and aims: Infusion-associated reactions (IARs) occur in >90% patients with multiple sclerosis (MS) treated with alemtuzumab. We aimed to investigate modified premedication scheme consisting of 1g/day of IV methylprednisolone throughout all 5 days of alemtuzumab treatment.
Methods: This was retrospective chart review of 38 consecutive MS patients who were treated with alemtuzumab from June 2015 till February 2017 at Department of Neurology, University Hospital Center Zagreb, Croatia and Department of Neurology, University Medical Centre Ljubljana, Slovenia.
Results: Seventeen patients (44.7%) did not experience IARs. Skin reactions and fever were the most common IARs attributed to alemtuzumab infusions and they were most frequent on Day 5 and Day 1, respectively. We have observed significant differences in the occurrence of fever (p=0.005) depending on the site of alemtuzumab administration which could be explained by different antipyretics used; fever was absent in the Slovenian cohort because high doseintravenous metamizole was administered. In the Croatian cohort, in 3 patients IARs resulted in hospitalization, in all 3 cases due to worsening of preexisting neurological deficits associated with fever (in one patient paraparesis and in 2 patients cognitive dysfunction). In the Slovenian cohort in one patient the 5 cycle was administered with a 3 days delay due to rash. Two out of 9 treatments naïve, and 19 out of 29 patients who previously received immunomodulatory treatment had IARs (χ2=5.208, p=0.022).
Conclusion: Modified premedication scheme consisting of 1g/day of IV methylprednisolone throughout all 5 days of alemtuzumab treatment leads to reduction of IARs, especially skin reactions.
Disclosure:
SSJ: Reports no conflict of interest.
BB: Reports no conflict of interest.
AHL: Reports no conflict of interest.
MKS: Reporst no conflict of interest.
MH: Participated as clinical investigator and/or speaker for: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals.
Abstract: EP1749
Type: ePoster
Abstract Category: Therapy - disease modifying - 29 Risk management for disease modifying treatments
Background and aims: Infusion-associated reactions (IARs) occur in >90% patients with multiple sclerosis (MS) treated with alemtuzumab. We aimed to investigate modified premedication scheme consisting of 1g/day of IV methylprednisolone throughout all 5 days of alemtuzumab treatment.
Methods: This was retrospective chart review of 38 consecutive MS patients who were treated with alemtuzumab from June 2015 till February 2017 at Department of Neurology, University Hospital Center Zagreb, Croatia and Department of Neurology, University Medical Centre Ljubljana, Slovenia.
Results: Seventeen patients (44.7%) did not experience IARs. Skin reactions and fever were the most common IARs attributed to alemtuzumab infusions and they were most frequent on Day 5 and Day 1, respectively. We have observed significant differences in the occurrence of fever (p=0.005) depending on the site of alemtuzumab administration which could be explained by different antipyretics used; fever was absent in the Slovenian cohort because high doseintravenous metamizole was administered. In the Croatian cohort, in 3 patients IARs resulted in hospitalization, in all 3 cases due to worsening of preexisting neurological deficits associated with fever (in one patient paraparesis and in 2 patients cognitive dysfunction). In the Slovenian cohort in one patient the 5 cycle was administered with a 3 days delay due to rash. Two out of 9 treatments naïve, and 19 out of 29 patients who previously received immunomodulatory treatment had IARs (χ2=5.208, p=0.022).
Conclusion: Modified premedication scheme consisting of 1g/day of IV methylprednisolone throughout all 5 days of alemtuzumab treatment leads to reduction of IARs, especially skin reactions.
Disclosure:
SSJ: Reports no conflict of interest.
BB: Reports no conflict of interest.
AHL: Reports no conflict of interest.
MKS: Reporst no conflict of interest.
MH: Participated as clinical investigator and/or speaker for: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals.