Alemtuzumab is the newest disease-modifying
therapy approved for the treatment of relapsing
multiple sclerosis.
Alemtuzumab is an anti-CD52 targeted antibody that causes lysis of T and B lymphocytes, monocytes, natural killer cells, macrophages, and dendritic cells. Following its administration, a prolonged T-cell
lymphopenia results with emergence of a reconstituted immune system that differs in its composition from that pretreatment. In clinical trials,
alemtuzumab has shown impressive efficacy with regard to clinical and radiological outcomes in relapsing
multiple sclerosis, along with sustained long-term beneficial effects, and it is attractive for its once-yearly administration. Despite this, the occurrence of serious secondary autoimmune disorders,
infections, and a potential risk of
malignancy necessitates a careful evaluation of risks versus benefits for an individual patient prior to its use. The requirement of patient commitment to the intense mandatory monitoring program is also
a factor to be considered when incorporating
alemtuzumab into the treatment regimen.