Acute pneumonitis and pericarditis related to alemtuzumab therapy in relapsing-remitting multiple sclerosis

Blasco, María Rosario; Ramos, Antonio; Malo, Celia García; García‐Merino, Antonio

doi:10.1007/s00415-016-8306-x

Cited by 21 publications

(4 citation statements)

References 7 publications

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“…Pleural effusion is uncommon in DAH [ 3 ] but can be seen in pleuritis that has been reported as a serious infusion reaction in an MS patient treated with alemtuzumab [ 5 ]. Pericardial effusion along with pneumonitis was also described in another MS patient after the second alemtuzumab infusion [ 6 ]. As our patient also had pain on inspiration, we consider pleuritis caused by alemtuzumab as the most likely cause of the minimal pleural effusions.…”

Section: Discussionmentioning

confidence: 99%

Diffuse alveolar hemorrhage during alemtuzumab infusion in a patient with multiple sclerosis: a case report

Myro

Bjerke

Zarnovicky

et al. 2018

BMC Pharmacol Toxicol

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BackgroundDiffuse alveolar bleeding is a potentially life-threatening condition that can be induced by several drugs. Whereas fatal cases have been reported in patients treated for other indications, no report have so far been published in a patient with multiple sclerosis treated with alemtuzumab.Case presentationWe report a case of alemtuzumab-induced diffuse alveolar bleeding in a 29 year old woman with relapsing remitting multiple sclerosis. The patient developed acute shortness of breath, chest pain on inspiration and haemoptysis following the second infusion of alemtuzumab during the first treatment cycle. Computed tomography showed bilateral alveolar opacities. Bronchoscopy and broncho-alveolar lavage showed persistently bloody return with no evidence of infection. The symptoms resolved completely without treatment and control computed tomography performed one week later showed total resolution of pulmonary infiltrates.ConclusionThis is the first published report of diffuse alveolar bleeding in a patient with multiple sclerosis treated with alemtuzumab. Four similar cases in patients treated for multiple sclerosis and several fatal cases in patients treated for other conditions are registered at the World Health Organization database of suspected adverse events (VIgiBase©), underscoring that this is a serious and possibly under-recognized complication of alemtuzumab which can also occur in the treatment of multiple sclerosis. The clinician should consider the possibility of diffuse pulmonary haemorrhage in patients with sudden onset of respiratory distress and haemoptysis following administration of alemtuzumab for multiple sclerosis.

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Section: Discussionmentioning

confidence: 99%

Diffuse alveolar hemorrhage during alemtuzumab infusion in a patient with multiple sclerosis: a case report

Myro

Bjerke

Zarnovicky

et al. 2018

BMC Pharmacol Toxicol

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“…Systemic delivery of antibodies has been shown to result in colitis, pneumonitis and nephritis. 86 , 87 While serious adverse events are not anticipated in response to pulmonary delivery of mAbs the most likely sources would be immune responses to any foreign protein, 88 e.g. synthetic component of the antibody construct, 10 or to additives such as polyethylene glycol.…”

Section: Quality and Performance Measuresmentioning

confidence: 99%

Inhaled antibodies: Quality and performance considerations

Hickey

Stewart

2021

Human Vaccines & Immunotherapeutics

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The use of antibodies in the treatment of lung diseases is of increasing interest especially as the search for COVID-19 therapies has unfolded. Historically, the use of antibody therapy was based on multiple targets including receptors involved in local hyper-reactivity in asthma, viruses and micro-organisms involved in a variety of pulmonary infectious disease. Generally, protein therapeutics pose challenges with respect to formulation and delivery to retain activity and assure therapy. The specificity of antibodies amplifies the need for attention to molecular integrity not only in formulation but also during aerosol delivery for pulmonary administration. Drug product development can be viewed from considerations of route of administration, dosage form, quality, and performance measures. Nebulizers and dry powder inhalers have been used to deliver protein therapeutics and each has its advantages that should be matched to the needs of the drug and the disease. This review offers insight into quality and performance barriers and the opportunities that arise from meeting them effectively.

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“…Пациенты с пневмонитами на первом курсе прошли второй курс в соответствии с протоколом, и только у одной пациентки был второй эпизод. К сожалению, отсутствие специальных диагностических инструментов затрудняет выяснение причин подобной нежелательной реакции, однако высказывается предположение о цитокин-опосредованной этиологии [28]. Подобное наблюдение с развитием пневмонита, возникшего через один месяц после первого лечебного цикла алемтузумаба, недавно описано у 51-летней пациентки из Великобритании [29].…”

Section: опыт применения алемтузумаба в рутинной клинической практикеunclassified

Clinical efficacy and safety of alemtuzumab in postmarketing practice

Хачанова

2019

Med. sov.

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Clinical trials confirm alemtuzumab efficacy for multiple sclerosis treatment in terms of both conventional measures and combined criteria such as NEDA (no evidence of disease activity). However, established drug efficacy and convenient dosing schedule are balanced by the risk of serious adverse events. Therefore, it is necessary to inform physicians about the benefits of alemtuzumab therapy along with the pattern of its safety profile.The present review provides the analysis of alemtuzumab real-world studies in Europe, USA and other parts of the world. The information obtained can help physicians to prescribe and administer the drug properly and to perform effective safety monitoring for early detection of adverse events and saving the maximum treatment benefit for the patient.

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Acute pneumonitis and pericarditis related to alemtuzumab therapy in relapsing-remitting multiple sclerosis

Cited by 21 publications

References 7 publications

Diffuse alveolar hemorrhage during alemtuzumab infusion in a patient with multiple sclerosis: a case report

Diffuse alveolar hemorrhage during alemtuzumab infusion in a patient with multiple sclerosis: a case report

Inhaled antibodies: Quality and performance considerations

Clinical efficacy and safety of alemtuzumab in postmarketing practice

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