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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Alemtuzumab for multiple sclerosis.

Rachel Riera1, Gustavo J M Porfírio, Maria R Torloni

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Alemtuzumab (a CD52 antibody) demonstrated superior efficacy over interferon beta-1a in reducing relapses and disease progression in relapsing-remitting multiple sclerosis (MS) patients. While associated with more adverse events, it significantly reduced new MRI lesions.

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is a chronic, autoimmune CNS disease with unpredictable progression.
  • Current MS therapies aim to manage exacerbations and disability but lack comprehensive effectiveness.
  • Alemtuzumab, a monoclonal antibody targeting CD52, shows promise for MS treatment.

Purpose of the Study:

  • To evaluate the safety and efficacy of alemtuzumab in reducing disease activity in MS patients.
  • To compare alemtuzumab, alone or in combination, against placebo or other treatments.

Main Methods:

  • Systematic search of multiple databases and trial registries for randomized clinical trials (RCTs) up to April 2015.
  • Inclusion of RCTs comparing alemtuzumab with placebo or active comparators in adult MS patients.
  • Co-primary outcomes included relapse-free survival, sustained disease progression, and adverse events.

Main Results:

  • Three RCTs (1713 participants) compared alemtuzumab with subcutaneous interferon beta-1a in relapsing-remitting MS.
  • At 24 months, alemtuzumab (12 mg) improved relapse-free and progression-free survival, reduced new MRI lesions, but slightly increased adverse events compared to interferon beta-1a.
  • At 36 months, alemtuzumab (24 mg) also showed improved relapse-free and progression-free survival.

Conclusions:

  • Alemtuzumab (12 mg) demonstrated superior outcomes in relapse-free survival, progression-free survival, and MRI lesion reduction compared to interferon beta-1a at 24 months.
  • Alemtuzumab (24 mg) also showed benefits in survival outcomes at 36 months.
  • Further RCTs are needed to assess alemtuzumab's effects in other MS forms and against different therapies, focusing on broader outcomes and long-term safety.