Alemtuzumab, to be marketed as Lemtrada, is the latest drug treatment for people with relapsing remitting MS. It was approved by the National Health Service in the UK, and we have just received news that it has recently been positively recommended by the Pharmaceutical Benefits Advisory Committee (PBAC) in Australia for the Pharmaceutical Benefits Scheme (PBS) subsidy. This is good news indeed, and following negotiations between the pharmaceutical company and the PBAC it should become available in early 2015.
Results of two large studies were published in 2012, showed that the majority of people on the treatment experienced an overall improvement, or stabilisation, in disability over seven years.
Alemtuzumab is given as a course of daily infusions for 5 days for the first dosing followed by a 3 day course after each 12 months.
How alemtuzumab works
Alemtuzumab is a monoclonal antibody and acts by killing T-cells which form part of the immune system, which in MS mistakenly attack myelin. It is thought that the T-cells regenerated following treatment with alemtuzumab will not include those that destroy myelin.
Side effects and contraindictions
Almost a third of participants develop thyroid-related side effects; these are treatable but can mean lifelong thyroid medication.
Infusion related flu-like symptoms were reported as alemtuzumab suppresses the immune system. Those on treatment will be more vulnerable to infections such as colds and viruses for some time after the infusion.
Immune thrombocytopenic purpura (ITP), a blood clotting disorder, affected approximately 1 percent of people involved in trials; although potentially serious, it is treatable if caught early enough.
Less serious side effects were common with 90 percent experiencing infusion site reactions and 77 percent reporting infections.
Ongoing monitoring is essential
Given the potential side effects, patients receiving Lemtrada must agree to ongoing monthly monitoring of their blood chemistry for 48 months after the last infusion.
For more information please contact the MSWA Nursing team on 08 9365 4888 or email: enquiries@mswa.org.au