A case of autoimmune myositis after treatment with alemtuzumab for multiple sclerosis

Aouad, Patrick; Yiannikas, Con; Fernando, Suran L.; Parratt, John

doi:10.1177/2055217318819012

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…Consequently, the remaining five molecules (alemtuzumab, anakinra, adalimumab, abatacept, and cladribine) were further assessed using a structured, quantitative RBA, which is also used by regulatory authorities [ 27 , 28 ]. The results of this assessment led the expert board to exclude alemtuzumab due to safety issues [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

Section: Resultsmentioning

confidence: 99%

RETRACTED: An Innovative Tool for Evidence-Based, Personalized Treatment Trials in Mucopolysaccharidosis

et al. 2023

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Mucopolysaccharidosis (MPS) is a group of rare metabolic diseases associated with reduced life expectancy and a substantial unmet medical need. Immunomodulatory drugs could be a relevant treatment approach for MPS patients, although they are not licensed for this population. Therefore, we aim to provide evidence justifying fast access to innovative individual treatment trials (ITTs) with immunomodulators and a high-quality evaluation of drug effects by implementing a risk–benefit model for MPS. The iterative methodology of our developed decision analysis framework (DAF) consists of the following steps: (i) a comprehensive literature analysis on promising treatment targets and immunomodulators for MPS; (ii) a quantitative risk–benefit assessment (RBA) of selected molecules; and (iii) allocation phenotypic profiles and a quantitative assessment. These steps allow for the personalized use of the model and are in accordance with expert and patient representatives. The following four promising immunomodulators were identified: adalimumab, abatacept, anakinra, and cladribine. An improvement in mobility is most likely with adalimumab, while anakinra might be the treatment of choice for patients with neurocognitive involvement. Nevertheless, an RBA should always be completed on an individual basis. Our evidence-based DAF model for ITTs directly addresses the substantial unmet medical need in MPS and characterizes a first approach toward precision medicine with immunomodulatory drugs.

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Section: Resultsmentioning

confidence: 99%

RETRACTED: An Innovative Tool for Evidence-Based, Personalized Treatment Trials in Mucopolysaccharidosis

et al. 2023

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“…3,4 Another proposed mechanism involves T cell repopulation pathway, with homeostatic proliferation of cells escaping depletion predominating over thymic reconstitution-resulting in a less varied repertoire of T lymphocytes driven by IL-21-that has been linked to a higher risk of secondary autoimmunity. 12,13 Other autoimmune disorders after ALZ, such as myositis, 14 vasculitis, 15 hemolytic anemia, 16,17 or autoimmune hepatitis, 18 are reported in the clinical literature. Skin AEs are common during infusion of the drug, and pruritic skin rash is very frequent.…”

Section: Discussionmentioning

confidence: 99%

“…Other autoimmune disorders after ALZ, such as myositis, 14 vasculitis, 15 hemolytic anemia, 16,17 or autoimmune hepatitis, 18 are reported in the clinical literature. Skin AEs are common during infusion of the drug, and pruritic skin rash is very frequent.…”

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confidence: 99%

Skin Autoimmunity Secondary to Alemtuzumab in a Tertiary Care Spanish Hospital

et al. 2022

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Background and Objective:The most common adverse events following Alemtuzumab include adverse infusion reactions, infections and autoimmune disorders. Skin adverse events are common during infusion but there are few reported cases of long-term skin autoimmune disease.Methods:A retrospective case series of patients developing long-term autoimmune skin disorders following alemtuzumab administration in a tertiary care hospital.Results:Of 133 patients treated with alemtuzumab, eight patients (6.02%) developed nine autoimmune cutaneous adverse events, including four events of alopecia areata, two of vitiligo, two of chronic urticaria and one of inflammatory atrichia. Three of them occurred between the first and the second infusion.Discussion:The lesions described are secondary to autoimmune disorders, probably related to immune dysregulation due to a differential lymphocyte repopulation following alemtuzumab. Autoimmune cutaneous adverse events may be frequent, and it would be recommended to monitor its appearance in order to treat them.

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“…The most frequently affected organ was the thyroid, with up to 29% of patients developing thyroiditis [ 254 ], followed by idiopathic thrombopenic purpura (ITP) [ 255 ], and Goodpasture Syndrome with autoantibodies against the glomerular basement membrane [ 256 ]. Many other autoimmune conditions have been reported with alemtuzumab including but not limited to immune-mediated neutropenia and autoimmune hemolytic anemia [ 257 ], diabetes mellitus type 1 [ 258 ], Still’s disease [ 259 ], myositis [ 260 ] and alopecia areata universalis [ 261 ]. Although most alemtuzumab-associated autoimmune conditions are autoantibody-mediated some others such as alemtuzumab-related vitiligo are T cell mediated [ 262 ].…”

Section: Safety Considerations Of Mabsmentioning

confidence: 99%

Monoclonal Antibodies as Neurological Therapeutics

et al. 2021

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Over the last 30 years the role of monoclonal antibodies in therapeutics has increased enormously, revolutionizing treatment in most medical specialties, including neurology. Monoclonal antibodies are key therapeutic agents for several neurological conditions with diverse pathophysiological mechanisms, including multiple sclerosis, migraines and neuromuscular disease. In addition, a great number of monoclonal antibodies against several targets are being investigated for many more neurological diseases, which reflects our advances in understanding the pathogenesis of these diseases. Untangling the molecular mechanisms of disease allows monoclonal antibodies to block disease pathways accurately and efficiently with exceptional target specificity, minimizing non-specific effects. On the other hand, accumulating experience shows that monoclonal antibodies may carry class-specific and target-associated risks. This article provides an overview of different types of monoclonal antibodies and their characteristics and reviews monoclonal antibodies currently in use or under development for neurological disease.

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A case of autoimmune myositis after treatment with alemtuzumab for multiple sclerosis

Cited by 6 publications

References 7 publications

RETRACTED: An Innovative Tool for Evidence-Based, Personalized Treatment Trials in Mucopolysaccharidosis

RETRACTED: An Innovative Tool for Evidence-Based, Personalized Treatment Trials in Mucopolysaccharidosis

Skin Autoimmunity Secondary to Alemtuzumab in a Tertiary Care Spanish Hospital

Monoclonal Antibodies as Neurological Therapeutics

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