Contributions
Abstract: EP1637
Type: Poster Sessions
Abstract Category: Therapy - Long-term treatment monitoring
Introduction: Alemtuzumab is a humanized monoclonal antibody approved for the treatment of active relapsing remitting multiple sclerosis (RRMS). Its mechanism of action involves selective binding to CD52, a cell surface antigen on B and T lymphocytes. A course of alemtuzumab, administered over 5 days or 3 days, depletes lymphocyte counts but as the drug spares precursor cells, T and B lymphocytes repopulate starting within weeks of the initial depletion. Alemtuzumab is related with dermatological adverse events, like urticaria or rash reported as Infusion Associated Reactions; but there are few cases reported about long-term dermatological disorders caused by the drug.
Objectives: To describe skin problems in patients who received alemtuzumab in patients with RRMS.
Methods: Observational and retrospective study of patients treated with alemtuzumab in Hospital Universitario Virgen Macarena (UEMAC) and University Hospital Center Zagreb since April 2009 to May 2018 that developed skin disorders after alemtuzumab.
Results: 196 patients were treated with alemtuzumab, and 9 of them (3 men, 6 women) developed skin disorders after drug. Average age was 39 years (31-50) Among these disorders were alopecia areata (2), vitiligo (2), impetigo (1), common skin warts (1), acne (2) and dermatitis (1). Median time of skin disorder since Alemtuzumab was started: 10 months (2-102). Both vitiligo appears before the first cycle (6 and 11 months). The majority of these infections were mild or moderate, and there were no cases of treatment discontinuation owing to dermatological reactions.
Conclusions: These skin lesions have a pathophysiological basis in which the immune system is involved, whether as an autoimmune, infectious or inflammatory reaction.
Few skin adverse events have been reported in RRMS patients who received Alemtuzumab. Only one case of alopecia universallis associated with the treatment was published. These auotimmune disorder is probably due to the immune reconstitution that causes prolonged alterations in the lymphocyte count, with relatively increased regulatory T-cell numbers and reduced naïve T cells.
We insist on the need to make a careful clinical observation of alemtuzumab-treated patients and refer them to a dermatologist for early care and treatment. More real-life data will be needed in patients treated with alemtuzumab to determine the actual prevalence of dermatological lesions and their relationship to the drug.
Disclosure: María Ruiz de Arcos: Nothing to disclose.
Sara Eichau received speaking honoraria from Biogen, Novartis, Sanofi Genzyme and Merck Serono.
Mario Habek participated as clinical investigator and/or speaker for: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals, TGI pharmaceuticals.
Ivan Adamec participated as clinical investigator and/or speaker for: Sanofi Genzyme, Novartis, Pliva/Teva, Roche, Alexion Pharmaceuticals.
Rocío López Ruiz received speaking honoraria from Biogen, Novartis, Sanofi Genzyme, Mylan and Merck Serono.
Cristina García Campos: nothing to disclose.
Alejandro Fuerte Hortigón: nothing to disclose.
Estefanía Chavero Moreno: nothing to disclose.
Juan Luis Ruiz-Peña received speaker honoraria from Biogen-Idec, Sanofi Genzyme, Merck-Serono, Teva and Novartis and Almirall
María Dolores Páramo Camino received speaker honoraria from Sanofi Genzyme.
Guillermo Navarro Mascarell had travel/accommodations/meeting expenses funded by Biogen, Merck Serono, Novartis, Sanofi Genzyme, and Teva.
Abstract: EP1637
Type: Poster Sessions
Abstract Category: Therapy - Long-term treatment monitoring
Introduction: Alemtuzumab is a humanized monoclonal antibody approved for the treatment of active relapsing remitting multiple sclerosis (RRMS). Its mechanism of action involves selective binding to CD52, a cell surface antigen on B and T lymphocytes. A course of alemtuzumab, administered over 5 days or 3 days, depletes lymphocyte counts but as the drug spares precursor cells, T and B lymphocytes repopulate starting within weeks of the initial depletion. Alemtuzumab is related with dermatological adverse events, like urticaria or rash reported as Infusion Associated Reactions; but there are few cases reported about long-term dermatological disorders caused by the drug.
Objectives: To describe skin problems in patients who received alemtuzumab in patients with RRMS.
Methods: Observational and retrospective study of patients treated with alemtuzumab in Hospital Universitario Virgen Macarena (UEMAC) and University Hospital Center Zagreb since April 2009 to May 2018 that developed skin disorders after alemtuzumab.
Results: 196 patients were treated with alemtuzumab, and 9 of them (3 men, 6 women) developed skin disorders after drug. Average age was 39 years (31-50) Among these disorders were alopecia areata (2), vitiligo (2), impetigo (1), common skin warts (1), acne (2) and dermatitis (1). Median time of skin disorder since Alemtuzumab was started: 10 months (2-102). Both vitiligo appears before the first cycle (6 and 11 months). The majority of these infections were mild or moderate, and there were no cases of treatment discontinuation owing to dermatological reactions.
Conclusions: These skin lesions have a pathophysiological basis in which the immune system is involved, whether as an autoimmune, infectious or inflammatory reaction.
Few skin adverse events have been reported in RRMS patients who received Alemtuzumab. Only one case of alopecia universallis associated with the treatment was published. These auotimmune disorder is probably due to the immune reconstitution that causes prolonged alterations in the lymphocyte count, with relatively increased regulatory T-cell numbers and reduced naïve T cells.
We insist on the need to make a careful clinical observation of alemtuzumab-treated patients and refer them to a dermatologist for early care and treatment. More real-life data will be needed in patients treated with alemtuzumab to determine the actual prevalence of dermatological lesions and their relationship to the drug.
Disclosure: María Ruiz de Arcos: Nothing to disclose.
Sara Eichau received speaking honoraria from Biogen, Novartis, Sanofi Genzyme and Merck Serono.
Mario Habek participated as clinical investigator and/or speaker for: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals, TGI pharmaceuticals.
Ivan Adamec participated as clinical investigator and/or speaker for: Sanofi Genzyme, Novartis, Pliva/Teva, Roche, Alexion Pharmaceuticals.
Rocío López Ruiz received speaking honoraria from Biogen, Novartis, Sanofi Genzyme, Mylan and Merck Serono.
Cristina García Campos: nothing to disclose.
Alejandro Fuerte Hortigón: nothing to disclose.
Estefanía Chavero Moreno: nothing to disclose.
Juan Luis Ruiz-Peña received speaker honoraria from Biogen-Idec, Sanofi Genzyme, Merck-Serono, Teva and Novartis and Almirall
María Dolores Páramo Camino received speaker honoraria from Sanofi Genzyme.
Guillermo Navarro Mascarell had travel/accommodations/meeting expenses funded by Biogen, Merck Serono, Novartis, Sanofi Genzyme, and Teva.