alemtuzumab (Campath-1H, Lemtrada)
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Indications
- treatment of refractory leukemia (B-CLL) (FDA approved 2001)
- relapsing-remitting multiple sclerosis (Lemtrada)[5]*
- treatment of mycosis fungoides[3][4]
* on list of drugs to avoid for treatment of muliple sclerosis[6]
- disproportionate adverse effects cited
Contraindications
Dosage
- 12 mg IV daily for 5 days at baseline, then daily for 3 days at 12 months
Monitor
- pretreatment screening for varicella vaccination
- thyroid function testing every 3 months
- monthly CBC, urinalysis, serum creatinine[3]
Adverse effects
- infusion reactions including headache, rash
- reactivation of viral infection (cytomegalovirus)
- infusion-associated reactions (90%)
- infection 77%* (mostly mild-to-moderate)
- thyroid disorders (16%)[2]
- immune thrombocytopenia (1%)
- hepatotoxicity[6]
- stroke, tears in blood vessel walls (rare)[7]
* compared with 66% for IFN-beta-1a (infections)
Mechanism of action
- binds to CDw52 (CAMPATH-1 antigen)
Notes
Manufacturer: Berlex
More general terms
Additional terms
References
- ↑ Prescriber's Letter 9(2):S1 2002
- ↑ 2.0 2.1 Cohen JA et al. Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: A randomised controlled phase 3 trial. Lancet 2012 Nov 24; 380:1819. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23122652
Coles AJ et al. Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: A randomised controlled phase 3 trial. Lancet 2012 Nov 24; 380:1829. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23122650 - ↑ 3.0 3.1 3.2 3.3 3.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018.
- ↑ 4.0 4.1 Galper SL, Smith BD, Wilson LD. Diagnosis and management of mycosis fungoides. Oncology (Williston Park). 2010 May;24(6):491-501. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20568590
- ↑ 5.0 5.1 Genzyme's Lemtrada Approved by the FDA Manufacturer's Press Release. November 14, 2014 http://news.genzyme.com/press-release/genzymes-lemtrada-approved-fda
- ↑ 6.0 6.1 6.2 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
- ↑ 7.0 7.1 FDA Safety Announcement. Nov 29, 2018 FDA warns about rare but serious risks of stroke and blood vessel wall tears with multiple sclerosis drug Lemtrada (alemtuzumab). https://www.fda.gov/Drugs/DrugSafety/ucm624247.htm