alemtuzumab at a glance
Medicine class
Humanised anti-CD52 monoclonal antibody and disease-modifying immunotherapy
Licensed use
Highly active relapsing-remitting multiple sclerosis in eligible adults
Administration
Diluted and given by intravenous infusion in a specialist hospital
Long-term monitoring
Regular blood, urine and thyroid tests are needed because delayed autoimmune effects can occur
What is alemtuzumab used for?
Licensed and specialist non-licensed uses differ.
Licensed use: single disease-modifying therapy for adults with highly active relapsing-remitting multiple sclerosis despite adequate treatment with another disease-modifying therapy, or with rapidly evolving severe disease as defined in the SmPC.
Some transplant centres use it to prevent or treat transplant rejection under separate specialist protocols. This is outside the licence of the selected MS product.
How does alemtuzumab work?
Alemtuzumab binds CD52, found mainly on circulating T and B lymphocytes, causing marked depletion. When these cells repopulate, the balance and behaviour of the immune system changes. This may reduce immune attacks on the brain and spinal cord, although the full mechanism in MS is not completely understood.
alemtuzumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 12 mg
How to take alemtuzumab
Alemtuzumab is not taken at home. It is diluted and infused into a vein in hospital, where serious reactions can be recognised and treated. Medicines may be given beforehand to reduce infusion reactions, followed by observation.
Keep and carry the alert card supplied by the specialist team.
Tell the team about infections, vaccinations and all medicines before an infusion appointment.
Avoid uncooked or undercooked meat, soft cheeses and unpasteurised dairy products around treatment as directed, to reduce listeriosis risk.
alemtuzumab side effects
Common or expected effects
- Infusion reactions, including rash, itching, hives, flushing, fever, headache, nausea or a fast heartbeat
- Upper respiratory, urinary or herpes-virus infections
- Reduced lymphocyte or white-cell counts
- Overactive or underactive thyroid
- Dizziness, muscle or joint pain, and tiredness
Get urgent medical advice
- Severe infusion reaction, anaphylaxis or cytokine-release syndrome
- Heart attack, stroke, cervicocephalic arterial dissection or bleeding into the lungs
- Immune thrombocytopenia, acquired haemophilia or thrombotic thrombocytopenic purpura
- Autoimmune thyroid, kidney or liver disease
- Serious or opportunistic infection, including listeriosis, tuberculosis or progressive multifocal leukoencephalopathy
- Autoimmune encephalitis or haemophagocytic lymphohistiocytosis
alemtuzumab in pregnancy
Human pregnancy information is limited. Alemtuzumab should be used during pregnancy only when the potential benefit justifies the potential fetal risk. Effective contraception is advised during treatment and for four months after treatment. Anyone planning a pregnancy or becoming pregnant should contact their neurologist promptly; thyroid function needs particular attention.
alemtuzumab while breastfeeding
It is unknown whether alemtuzumab enters human milk, and risk to a breastfed infant cannot be excluded. The product information advises stopping breastfeeding during treatment and for four months afterwards. Discuss the individual plan with neurology and maternity teams.
alemtuzumab interactions
Formal interaction studies in people receiving alemtuzumab for MS are limited. The specialist team should review prescribed, over-the-counter and herbal products.
Antineoplastic or other immunosuppressive treatments
Combined immune suppression may increase infection and other immune-related risks; concurrent or recent use requires specialist assessment.
Antiplatelets, anticoagulants or medicines affecting clotting
The selected product is contraindicated in people receiving antiplatelet or anticoagulant treatment because of bleeding-related safety concerns.
Live viral vaccines
Safety after recent treatment has not been established. Do not receive live viral vaccines without specialist approval.
Common questions about alemtuzumab
Answers are fully visible for fast scanning and source review.
What is alemtuzumab used for in multiple sclerosis?
It is licensed for defined adults with highly active relapsing-remitting MS, including disease that remains highly active despite another disease-modifying treatment or is rapidly evolving and severe.
Why is alemtuzumab given in hospital?
Serious infusion-related, cardiovascular, bleeding or allergic reactions can occur, so monitoring and immediate access to specialist emergency care are required.
Why are blood and urine tests needed?
They help detect delayed autoimmune effects involving blood cells, kidneys, liver or thyroid before severe complications develop.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.