Autoimmune disease after alemtuzumab treatment for multiple sclerosis in a multicenter cohort

Cossburn, M.; Pace, A.A.; Jones, J.; Ali, R.; Ingram, G.; Baker, K.; Hirst, C.; Zajicek, J.; Scolding, N.; Boggild, M.; Pickersgill, T.; Ben-Shlomo, Y.; Coles, A.; Robertson, N.P.

doi:10.1212/wnl.0b013e318228bec5

Cited by 216Multiple Sclerosis Research StudiesAutoimmune Neurological Disorders and TreatmentsSystemic Lupus Erythematosus Research

Autoimmune disease after alemtuzumab treatment for multiple sclerosis in a multicenter cohort

Cossburn, M., Pace, A.A., Jones, J., Ali, R., Ingram, G., Baker, K., Hirst, C., Zajicek, J. +6 more·2011·Neurology

DOI 10.1212/wnl.0b013e318228bec5

Open this paper in CoChat — free account

Abstract

OBJECTIVE: To define the rate, timing, and clinical risk factors for the development of autoimmune disease (AID) after alemtuzumab treatment for multiple sclerosis (MS). METHODS: We analyzed prospective clinical and serologic data from 248 patients with MS treated with alemtuzumab, with median follow-up of 34.3 months (range 6.7-107.3). RESULTS: Novel AID developed in 22.2%. Thyroid AID was most frequent (15.7%). A range of hematologic, renal, and dermatologic AID were also observed as was asymptomatic development of novel autoantibodies. AID was seen from 2 weeks after initial treatment and was most frequent 12-18 months after first treatment. No new cases of AID were identified 60 months or more after initial treatment and risk of AID was independent of total alemtuzumab dose or interval of dosage. While established risk factors for AID including sex and age had no impact on AID frequency, both family history (odds ratio = 7.31, 95% confidence interval 3.02-17.68) of AID and a personal smoking history (odds ratio = 3.05, 95% confidence interval 1.50-6.19) were predictive of AID expression. CONCLUSIONS: Cumulative risk for AID in MS following alemtuzumab is 22.2%, most frequent between 12 and 18 months following first dose and evident for up to 5 years. Individual risk is modified by smoking and family history, which should be incorporated within the counseling process prior to treatment. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that the risk of AID after alemtuzumab treatment for MS is time-limited and modified by external factors.

Integrity signals

Registry

Crossref · 10.1212/wnl.0b013e318228bec5

Cites

23 of 23 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Other studies did not report spontaneous resolution of post-IRT Graves' disease.
“while others did not [12, 77].”
From 2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy (2019) · cites this paper as [77]
In the studies that have reported treatment for alemtuzumab-induced Graves' disease, most patients responded to antithyroid drugs (ATDs), at least initially.
“In the studies that have, most patients responded to antithyroid drugs (ATDs) [1214, 50, 77], at least initially.”
From 2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy (2019) · cites this paper as [77]
In contrast, requirements for RAI or surgery were lower than expected in conventional Graves' disease in some reports; 14% and 27%.
“In contrast, requirements for RAI or surgery were lower than expected in conventional GD in some reports; 14% [14], 27% [77].”
From 2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy (2019) · cites this paper as [77]

Alemtuzumab vs. Interferon Beta-1a in Early Multiple Sclerosis
The CAMMS Trial Investigators (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0802670 · Cited by 1,012 · see citing works
Homeostatic expansion of T cells during immune insufficiency generates autoimmunity.
King, C., Ilic, A., Koelsch, K., & Sarvetnick, N. (2004) · Cell · doi:10.1016/s0092-8674(04)00335-6 · Cited by 747 · see citing works
The window of therapeutic opportunity in multiple sclerosis
Coles, A. J., Cox, A., Page, E. L., Jones, J., Trip, S. A., Deans, J., Seaman, S. R., Miller, D. H., Hale, G., Waldmann, H., et al. (2005) · Journal of Neurology · doi:10.1007/s00415-005-0934-5 · Cited by 506 · see citing works
Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosis
Coles, A. J., Wing, M., Smith, S., Coraddu, F., Greer, S., Taylor, C., Weetman, A., Hale, G., Chatterjee, V. K., Waldmann, H., et al. (1999) · The Lancet · doi:10.1016/s0140-6736(99)02429-0 · Cited by 453 · see citing works
Tobacco smoking, but not Swedish snuff use, increases the risk of multiple sclerosis
Hedström, A. K., Bäärnhielm, M., Olsson, T. P., & Alfredsson, L. S. (2009) · Neurology · doi:10.1212/wnl.0b013e3181b59c40 · Cited by 323 · see citing works
IL-21 drives secondary autoimmunity in patients with multiple sclerosis, following therapeutic lymphocyte depletion with alemtuzumab (Campath-1H)
Jones, J., Phuah, C., Cox, A. L., Thompson, S. A. J., Ban, M., Shawcross, J., Walton, A., Sawcer, S. J., Compston, A., & Coles, A. J. (2009) · Journal of Clinical Investigation · doi:10.1172/jci37878 · Cited by 297 · see citing works
Prevalence of immune thrombocytopenia: analyses of administrative data
Segal, J. B., & Powe, N. R. (2006) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2006.02147.x · Cited by 269 · see citing works
Autoimmune disease in first-degree relatives of patients with multiple sclerosis
Broadley, S., Deans, J., Sawcer, S. J., Clayton, D. G., & Compston, D. A. S. (2000) · Brain · doi:10.1093/brain/123.6.1102 · Cited by 210 · see citing works
Cigarette smoke extract induces thymic stromal lymphopoietin expression, leading to TH2-type immune responses and airway inflammation
Nakamura, Y., Miyata, M., Ohba, T., Ando, T., Hatsushika, K., Suenaga, F., Shimokawa, N., Ohnuma, Y., Katoh, R., Ogawa, H., et al. (2008) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2008.09.022 · Cited by 158 · see citing works
Smoking as a Risk Factor for Graves' Disease, Toxic Nodular Goiter, and Autoimmune Hypothyroidism
Vestergaard, P., Rejnmark, L., Weeke, J., Hoeck, H. C., NIELSEN, H. K., Rungby, J., Laurberg, P., & Mosekilde, L. (2002) · Thyroid · doi:10.1089/105072502753451995 · Cited by 128 · see citing works
Campath 1-H treatment in patients with aggressive relapsing remitting multiple sclerosis
Hirst, C. L., Pace, A., Pickersgill, T. P., Jones, R., McLean, B., Zajicek, J., Scolding, N. J., & Robertson, N. P. (2008) · Journal of Neurology · doi:10.1007/s00415-008-0696-y · Cited by 87 · see citing works
Campath-1H treatment of multiple sclerosis: lessons from the bedside for the bench
Coles, A. J., Deans, J., & Compston, A. (2004) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2004.02.013 · Cited by 85 · see citing works
Monoclonal Antibody Therapy of Chronic Lymphocytic Leukemia
Mavromatis, B. H., & Cheson, B. D. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.09.113 · Cited by 84 · see citing works
Prevalence of autoimmune thyroiditis and non-immune thyroid disease in multiple sclerosis
Niederwieser, G., Buchinger, W., Bonelli, R. M., Berghold, A., Reisecker, F., K�ltringer, P., & Archelos, J. J. (2003) · Journal of Neurology · doi:10.1007/s00415-003-1053-9 · Cited by 81 · see citing works
Increased levels of (class switched) memory B cells in peripheral blood of current smokers
Brandsma, C., Hylkema, M. N., Geerlings, M., van Geffen, W. H., Postma, D. S., Timens, W., & Kerstjens, H. A. M. (2009) · Respiratory Research · doi:10.1186/1465-9921-10-108 · Cited by 80 · see citing works
T cell senescence and contraction of T cell repertoire diversity in patients with chronic obstructive pulmonary disease
Lambers, C., Hacker, S., Posch, M., Höetzenecker, K., Pollreisz, A., Lichtenauer, M., Klepetko, W., & Ankersmit, H. J. (2009) · Clinical & Experimental Immunology · doi:10.1111/j.1365-2249.2008.03835.x · Cited by 75 · see citing works
A Personal History of the CAMPATH-1H Antibody
Waldmann, H. (2002) · Medical Oncology · doi:10.1385/mo:19:2s:s03 · Cited by 50 · see citing works
Differential gene expression analysis in human monocyte-derived macrophages: Impact of cigarette smoke on host defence
Doyle, I., Ratcliffe, M., Walding, A., Bon, E. V., Dymond, M., Tomlinson, W., Tilley, D., Shelton, P. A., & Dougall, I. G. (2009) · Molecular Immunology · doi:10.1016/j.molimm.2009.11.008 · Cited by 33 · see citing works
Smokers and passive smokers gene expression profiles: Correlation with the DNA oxidation damage
Lodovici, M., Luceri, C., Filippo, C. D., Romualdi, C., Bambi, F., & Dolara, P. (2007) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2007.04.018 · Cited by 27 · see citing works
Complement levels in cigarette smokers: elevation of serum concentrations of C5, C9, and C1-inhibitor.
Wyatt, R. J., Bridges, R. B., & Dg, H. (1981) · PubMed · Cited by 21 · see citing works
Engineering multiple-domain forms of the therapeutic antibody CAMPATH-1H: effects on complement lysis.
Greenwood, J., Gorman, S. D., Routledge, E. G., LLOYD, I. S., & Waldmann, H. (1994) · PubMed · Cited by 20 · see citing works
Association sclérose en plaques et thrombopénie auto-immune
Granier, H., Bellard, S., Nicolas, X., Laborde, J. P., & Talarmin, F. (2001) · La Revue de Médecine Interne · doi:10.1016/s0248-8663(01)00502-1 · Cited by 9 · see citing works
Human autoimmune thyroid disease: risk factors.
Cl, B., & Bresler, H. S. (1990) · PubMed · Cited by 3 · see citing works

Flagged first, then by citations

Sorted by citations

Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies
Wingerchuk, D. M., & Carter, J. L. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2013.11.002 · Cited by 416 · see citing works
Reaching an evidence-based prognosis for personalized treatment of multiple sclerosis
Rotstein, D., & Montalbán, X. (2019) · Nature Reviews Neurology · doi:10.1038/s41582-019-0170-8 · Cited by 290 · see citing works
B cells and antibodies in multiple sclerosis pathogenesis and therapy
Krumbholz, M., Derfuss, T. J., Hohlfeld, R., & Meinl, E. (2012) · Nature Reviews Neurology · doi:10.1038/nrneurol.2012.203 · Cited by 266 · see citing works
Comorbidity in multiple sclerosis: implications for patient care
Marrie, R. A. (2017) · Nature Reviews Neurology · doi:10.1038/nrneurol.2017.33 · Cited by 250 · see citing works
Alemtuzumab in Multiple Sclerosis: Mechanism of Action and Beyond
Ruck, T., Bittner, S., Wiendl, H., & Meuth, S. G. (2015) · International Journal of Molecular Sciences · doi:10.3390/ijms160716414 · Cited by 213 · see citing works
T cell regulation mediated by interaction of soluble CD52 with the inhibitory receptor Siglec-10
Bandala‐Sanchez, E., Zhang, Y., Reinwald, S., Dromey, J. A., Lee, B.-H., Qian, J., Böhmer, R. M., & Harrison, L. C. (2013) · Nature Immunology · doi:10.1038/ni.2610 · Cited by 199 · see citing works
A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis
Marrie, R. A., Reider, N., Cohen, J. A., Stüve, O., Sørensen, P. S., Cutter, G., Reingold, S. C., & Trojano, M. (2014) · Multiple Sclerosis Journal · doi:10.1177/1352458514564490 · Cited by 195 · see citing works
Autoimmune diseases induced by biological agents. A review of 12,731 cases (BIOGEAS Registry)
Pérez-De-Lis, M., Retamozo, S., Flores-Chávez, A., Kostov, B., Pérez-Álvarez, R., Brito‐Zerón, P., & Ramos‐Casals, M. (2017) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2017.1372421 · Cited by 149 · see citing works
Established and novel disease‐modifying treatments in multiple sclerosis
Cross, A. H., & Naismith, R. T. (2014) · Journal of Internal Medicine · doi:10.1111/joim.12203 · Cited by 142 · see citing works
Aggressive multiple sclerosis: proposed definition and treatment algorithm
Rush, C., MacLean, H. J., & Freedman, M. S. (2015) · Nature Reviews Neurology · doi:10.1038/nrneurol.2015.85 · Cited by 128 · see citing works
Current multiple sclerosis treatments have improved our understanding of MS autoimmune pathogenesis
Martinꝉ, R., Sospedra, M., Rosito, M., & Engelhardt, B. (2016) · European Journal of Immunology · doi:10.1002/eji.201646485 · Cited by 125 · see citing works
Current and emerging therapies in multiple sclerosis: a systematic review
Castro-Borrero, W., Graves, D. F., Frohman, T. C., Flores, A., Hardeman, P., Logan, D., Orchard, M., Greenberg, B. M., & Frohman, E. M. (2012) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756285612450936 · Cited by 122 · see citing works
The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations
Pardo, G., & Jones, D. (2017) · Journal of Neurology · doi:10.1007/s00415-017-8594-9 · Cited by 119 · see citing works
Highly active multiple sclerosis: An update
Díaz, C., Zarco, L. A., & Rivera, D. M. (2019) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2019.01.039 · Cited by 116 · see citing works
Risks and risk management in modern multiple sclerosis immunotherapeutic treatment
Klotz, L., Havla, J. B., Schwab, N., Hohlfeld, R., Barnett, M. H., Reddel, S., & Wiendl, H. (2019) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756286419836571 · Cited by 110 · see citing works
A distinctive form of immune thrombocytopenia in a phase 2 study of alemtuzumab for the treatment of relapsing-remitting multiple sclerosis
Cuker, A. C., Coles, A. J., Sullivan, H., Fox, E., Goldberg, M. A., Oyuela, P., Purvis, A., Beardsley, D. S., & Margolin, D. H. (2011) · Blood · doi:10.1182/blood-2011-08-371138 · Cited by 105 · see citing works
Alemtuzumab Induction Therapy in Kidney Transplantation
Morgan, R. D., O'Callaghan, J. M., Knight, S. R., & Morris, P. J. (2012) · Transplantation · doi:10.1097/tp.0b013e318257ad41 · Cited by 104 · see citing works
Epithelial-to-mesenchymal transition drives a pro-metastatic Golgi compaction process through scaffolding protein PAQR11
Tan, X., Banerjee, P., Guo, H., Ireland, S., Paňková, D., Ahn, Y., Nikolaidis, I. M., Liu, X., Zhao, Y., Xue, Y., et al. (2016) · Journal of Clinical Investigation · doi:10.1172/jci88736 · Cited by 103 · see citing works
Lymphodepletion and Homeostatic Proliferation: Implications for Transplantation
Tchao, N. K., & Turka, L. A. (2012) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2012.04008.x · Cited by 102 · see citing works
Alemtuzumab for multiple sclerosis: Long term follow-up in a multi-centre cohort
Willis, M., Harding, K. E., Pickersgill, T. P., Wardle, M., Pearson, O. R., Scolding, N. J., Smee, J., & Robertson, N. (2015) · Multiple Sclerosis Journal · doi:10.1177/1352458515614092 · Cited by 101 · see citing works
Secondary autoimmune diseases following alemtuzumab therapy for multiple sclerosis
Costelloe, L., Jones, J., & Coles, A. J. (2012) · Expert Review of Neurotherapeutics · doi:10.1586/ern.12.5 · Cited by 100 · see citing works
Managing the side effects of multiple sclerosis therapy: pharmacotherapy options for patients
Rommer, P. S., & Zettl, U. K. (2018) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2018.1446944 · Cited by 97 · see citing works
Therapeutic Decisions in Multiple Sclerosis
Brück, W., Gold, R., Lund, B. T., Oreja‐Guevara, C., Prat, A., Spencer, C. M., Steinman, L., Tintoré, M., Vollmer, T. L., Weber, M. S., et al. (2013) · JAMA Neurology · doi:10.1001/jamaneurol.2013.3510 · Cited by 96 · see citing works
Alemtuzumab-Induced Thyroid Dysfunction Exhibits Distinctive Clinical and Immunological Features
Pariani, N., Willis, M., Muller, I., Healy, S., Nasser, T., McGowan, A., Lyons, G., Jones, J., Chatterjee, K., Dayan, C., et al. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-00359 · Cited by 84 · see citing works
Self-citation
Recommendations for observational studies of comorbidity in multiple sclerosis
Marrie, R. A., Miller, A., Sormani, M. P., Thompson, A. J., Waubant, E. L., Trojano, M., O'Connor, P. W., Fiest, K. M., Reider, N., Reingold, S. C., et al. (2016) · Neurology · doi:10.1212/wnl.0000000000002474 · Cited by 82 · see citing works
Pregnancy and Family Planning in Multiple Sclerosis
Langer-Gould, A. M. (2019) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000000745 · Cited by 81 · see citing works
In Kidney Transplant Patients, Alemtuzumab but Not Basiliximab/Low-Dose Rabbit Anti-Thymocyte Globulin Induces B Cell Depletion and Regeneration, Which Associates with a High Incidence of De Novo Donor-Specific Anti-HLA Antibody Development
Todeschini, M., Cortinovis, M., Perico, N., Poli, F., Innocente, A., Cavinato, R. A., Gotti, E., Ruggenenti, P. L., Gaspari, F., Noris, M., et al. (2013) · The Journal of Immunology · doi:10.4049/jimmunol.1203261 · Cited by 81 · see citing works
Immunosuppressive drugs in organ transplantation to prevent allograft rejection: Mode of action and side effects
Claeys, E., & Vermeire, K. (2019) · Journal of Immunological Sciences · doi:10.29245/2578-3009/2019/4.1178 · Cited by 79 · see citing works
2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy
Muller, I., Moran, C., Lecumberri, B., Decallonne, B., Robertson, N., Jones, J., & Dayan, C. M. (2019) · European Thyroid Journal · doi:10.1159/000500881 · Cited by 78 · see citing works
Requirement for safety monitoring for approved multiple sclerosis therapies: an overview
Rommer, P. S., Zettl, U. K., Kieseier, B. C., Hartung, H.-P., Menge, T., Frohman, E. M., Greenberg, B. M., Hemmer, B., & Stüve, O. (2013) · Clinical & Experimental Immunology · doi:10.1111/cei.12206 · Cited by 79 · see citing works
Alemtuzumab Use in Clinical Practice: Recommendations from European Multiple Sclerosis Experts
Berger, T., Elovaara, I., Fredrikson, S., McGuigan, C., Moiola, L., Myhr, K., Oreja‐Guevara, C., Столяров, И. Д., & Zettl, U. K. (2016) · CNS Drugs · doi:10.1007/s40263-016-0394-8 · Cited by 77 · see citing works
Monoclonal Antibodies in the Treatment of Relapsing Multiple Sclerosis: an Overview with Emphasis on Pregnancy, Vaccination, and Risk Management
Krajnc, N., Bsteh, G., Berger, T., Mareš, J., & Hartung, H. (2022) · Neurotherapeutics · doi:10.1007/s13311-022-01224-9 · Cited by 75 · see citing works
Daclizumab: Mechanisms of Action, Therapeutic Efficacy, Adverse Events and Its Uncovering the Potential Role of Innate Immune System Recruitment as a Treatment Strategy for Relapsing Multiple Sclerosis
COHAN, S. L., Lucassen, E. B., Romba, M. C., & Linch, S. N. (2019) · Biomedicines · doi:10.3390/biomedicines7010018 · Cited by 74 · see citing works
Acute effects of alemtuzumab infusion in patients with active relapsing-remitting MS
Thomas, K., Eisele, J., Rodriguez-Leal, F. A., Hainke, U., & Ziemssen, T. (2016) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000000228 · Cited by 73 · see citing works
Management of hyperthyroidism due to Graves’ disease: frequently asked questions and answers (if any)
Bartalena, L., Chiovato, L., & Vitti, P. (2016) · Journal of Endocrinological Investigation · doi:10.1007/s40618-016-0505-x · Cited by 75 · see citing works
Multiple sclerosis: Therapeutic applications of advancing drug delivery systems
Dolati, S., Babaloo, Z., Jadidi‐Niaragh, F., Ayromlou, H., Sadreddini, S., & Yousefi, M. (2016) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2016.12.010 · Cited by 72 · see citing works
Alemtuzumab-induced thyroid events in multiple sclerosis: a systematic review and meta-analysis
Scappaticcio, L., Castellana, M., Virili, C., Bellastella, G., Centanni, M., Cannavò, S., Campennì, A., Ruggeri, R. M., Giovanella, L., & Trimboli, P. (2019) · Journal of Endocrinological Investigation · doi:10.1007/s40618-019-01105-7 · Cited by 70 · see citing works
Personalized medicine in multiple sclerosis: hope or reality?
Derfuss, T. J. (2012) · BMC Medicine · doi:10.1186/1741-7015-10-116 · Cited by 68 · see citing works
Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review
Giovannoni, G., & Mathews, J. (2022) · Neurology and Therapy · doi:10.1007/s40120-022-00339-7 · Cited by 67 · see citing works
Clinical relevance of differential lymphocyte recovery after alemtuzumab therapy for multiple sclerosis
Cossburn, M., Harding, K. E., Ingram, G., El‐Shanawany, T., Heaps, A. G., Pickersgill, T. P., Jolles, S. R. A., & Robertson, N. P. (2012) · Neurology · doi:10.1212/wnl.0b013e31827b5927 · Cited by 65 · see citing works
Differing trends in the incidence of vascular comorbidity in MS and the general population
Marrie, R. A., Fisk, J. D., Tremlett, H. L., Wolfson, C. M., Warren, S., Blanchard, J., Patten, S. B., for the CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis, CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis, Elliott, L. J., et al. (2016) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000000230 · Cited by 66 · see citing works
The Development of Cladribine Tablets for the Treatment of Multiple Sclerosis: A Comprehensive Review
Rammohan, K. W., Coyle, P. K., Sylvester, E., Galazka, A. R., Dangond, F., Grosso, M., & Leist, T. P. (2020) · Drugs · doi:10.1007/s40265-020-01422-9 · Cited by 62 · see citing works
A review on nanotechnology based innovations in diagnosis and treatment of multiple sclerosis
Ojha, S., & Kumar, B. (2017) · Journal of Cellular Immunotherapy · doi:10.1016/j.jocit.2017.12.001 · Cited by 60 · see citing works
The incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in multiple sclerosis: A systematic review
Marrie, R. A., Reider, N., Stüve, O., Trojano, M., Sørensen, P. S., Cutter, G., Reingold, S. C., & Cohen, J. A. (2014) · Multiple Sclerosis Journal · doi:10.1177/1352458514564488 · Cited by 57 · see citing works
Drugs in Development for Relapsing Multiple Sclerosis
Ali, R., Nicholas, R. S., & Muraro, P. A. (2013) · Drugs · doi:10.1007/s40265-013-0030-6 · Cited by 56 · see citing works
Immune status following alemtuzumab treatment in human CD52 transgenic mice
Turner, M. J., LaMorte, M. J., Chrétien, N., Havari, E., Roberts, B., Kaplan, J. M., & Siders, W. (2013) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2013.04.018 · Cited by 54 · see citing works
Depletion of CD 52‐positive cells inhibits the development of central nervous system autoimmune disease, but deletes an immune‐tolerance promoting CD 8 T‐cell population. Implications for secondary autoimmunity of alemtuzumab in multiple sclerosis
von Kutzleben, S., Pryce, G., Giovannoni, G., & Baker, D. (2016) · Immunology · doi:10.1111/imm.12696 · Cited by 54 · see citing works
Alemtuzumab for Multiple Sclerosis
Willis, M., & Robertson, N. P. (2016) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-016-0685-y · Cited by 54 · see citing works
Monoclonal antibodies in treatment of multiple sclerosis
Rommer, P. S., Dudešek, A., Stüve, O., & Zettl, U. (2013) · Clinical & Experimental Immunology · doi:10.1111/cei.12197 · Cited by 53 · see citing works
Treating multiple sclerosis with monoclonal antibodies: a 2013 update
Deiß, A., Brecht, I., Haarmann, A., & Buttmann, M. (2013) · Expert Review of Neurotherapeutics · doi:10.1586/ern.13.17 · Cited by 53 · see citing works
Alemtuzumab-induced immune phenotype and repertoire changes: implications for secondary autoimmunity
Ruck, T., Barman, S., Schulte‐Mecklenbeck, A., Pfeuffer, S., Steffen, F., Nelke, C., Schroeter, C. B., Willison, A., Heming, M., Müntefering, T., et al. (2022) · Brain · doi:10.1093/brain/awac064 · Cited by 52 · see citing works
Outcome Prediction of Treatment of Graves’ Hyperthyroidism with Antithyroid Drugs
Piantanida, E., Lai, A., Sassi, L., Gallo, D., Spreafico, E., Tanda, M. L., & Bartalena, L. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0035-1555759 · Cited by 53 · see citing works
Emerging strategies to bypass transplant rejection via biomaterial-assisted immunoengineering: Insights from islets and beyond
Abbaszadeh, S., Nosrati‐Siahmazgi, V., Musaie, K., Rezaei, S., Qahremani, M., Xiao, B., Santos, H. A., & Shahbazi, M. (2023) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2023.115050 · Cited by 51 · see citing works
Alemtuzumab
Menge, T., Stüve, O., Kieseier, B. C., & Hartung, H.-P. (2014) · Neurology · doi:10.1212/wnl.0000000000000540 · Cited by 50 · see citing works
Severe, Highly Active, or Aggressive Multiple Sclerosis
Freedman, M. S., & Rush, C. (2016) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000000331 · Cited by 49 · see citing works
Alemtuzumab for multiple sclerosis
Riera, R., Porfírio, G. J., & Torloni, M. R. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011203.pub2 · Cited by 46 · see citing works
Graves’ disease following immune reconstitution or immunomodulatory treatment: should we manage it any differently?
Weetman, A. P. (2014) · Clinical Endocrinology · doi:10.1111/cen.12427 · Cited by 46 · see citing works
Personalized Medicine in Multiple Sclerosis
Giovannoni, G. (2017) · Neurodegenerative Disease Management · doi:10.2217/nmt-2017-0035 · Cited by 46 · see citing works
Managing Multiple Sclerosis: Treatment Initiation, Modification, and Sequencing
Freedman, M. S., Selchen, D. H., Prat, A., & Giacomini, P. S. (2018) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2018.17 · Cited by 46 · see citing works
Endocrine disruption as an adverse effect of non-endocrine targeting pharmaceuticals
Sabir, S., Akhtar, M. F., & Saleem, A. (2018) · Environmental Science and Pollution Research · doi:10.1007/s11356-018-3774-4 · Cited by 46 · see citing works
Immunomodulation in multiple sclerosis: promises and pitfalls
Dendrou, C. A., & Fugger, L. H. (2017) · Current Opinion in Immunology · doi:10.1016/j.coi.2017.08.013 · Cited by 45 · see citing works
Neuro-ophthalmic side effects of molecularly targeted cancer drugs
Bhatti, M. T., & Salama, A. K. S. (2017) · Eye · doi:10.1038/eye.2017.222 · Cited by 44 · see citing works
CD52 Is Elevated on B cells of SLE Patients and Regulates B Cell Function
Bhamidipati, K., Silberstein, J. L., Chaichian, Y., Baker, M. C., Lanz, T. V., Zia, A., Rasheed, Y., Cochran, J. R., & Robinson, W. H. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2020.626820 · Cited by 41 · see citing works
The Incidence and Prevalence of Thyroid Disease Do Not Differ in the Multiple Sclerosis and General Populations: A Validation Study Using Administrative Data
Marrie, R. A., Yu, B. N., Leung, S., Elliott, L. J., Warren, S., Wolfson, C. M., Tremlett, H. L., Fisk, J. D., & Blanchard, J. (2012) · Neuroepidemiology · doi:10.1159/000339757 · Cited by 42 · see citing works
Monoclonal Antibodies and Recombinant Immunoglobulins for the Treatment of Multiple Sclerosis
Gensicke, H., Leppert, D., Yaldizli, Ö., Lindberg, R. L. P., Mehling, M., Kappos, L., & Kühle, J. (2011) · CNS Drugs · doi:10.2165/11596920-000000000-00000 · Cited by 40 · see citing works
Narcolepsy Type 1 as an Autoimmune Disorder: Evidence, and Implications for Pharmacological Treatment
Barateau, L., Liblau, R., Peyron, C., & Dauvilliers, Y. A. (2017) · CNS Drugs · doi:10.1007/s40263-017-0464-6 · Cited by 39 · see citing works
Induction Therapy for Patients with Multiple Sclerosis: Why? When? How?
Edan, G., & Page, E. L. (2013) · CNS Drugs · doi:10.1007/s40263-013-0065-y · Cited by 38 · see citing works
Thyroid disorders in alemtuzumab-treated multiple sclerosis patients: a Belgian consensus on diagnosis and management
Decallonne, B., Bartholome, E. J., Delvaux, V., D’haeseleer, M., Sankari, S. E., Seeldrayers, P., Wijmeersch, B. V., & Daumerie, C. (2018) · Acta Neurologica Belgica · doi:10.1007/s13760-018-0883-2 · Cited by 40 · see citing works
Mixed T Cell Chimerism After Allogeneic Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia Using an Alemtuzumab-Containing Regimen Is Shaped by Persistence of Recipient CD8 T Cells
Grimaldi, F., Potter, V. T., Abellan, P. P., Veluchamy, J. P., Atif, M., Grain, R., Sen, M., Best, S., Lea, N. C., Rice, C., et al. (2016) · Transplantation and Cellular Therapy · doi:10.1016/j.bbmt.2016.11.003 · Cited by 37 · see citing works
Tyrphostin AG126 exerts neuroprotection in CNS inflammation by a dual mechanism
Menzfeld, C., John, M., van Rossum, D., Regen, T., Scheffel, J., Jáňová, H., Götz, A. A., Ribes, S., Nau, R., Borisch, A., et al. (2015) · Glia · doi:10.1002/glia.22803 · Cited by 36 · see citing works
Alemtuzumab for the treatment of multiple sclerosis
Evan, J. R., Bozkurt, S. B., Thomas, N. C., & Bagnato, F. R. (2018) · Expert Opinion on Biological Therapy · doi:10.1080/14712598.2018.1425388 · Cited by 34 · see citing works
Adenosine A2A Receptor Signaling in the Immunopathogenesis of Experimental Autoimmune Encephalomyelitis
Rajasundaram, S. (2018) · Frontiers in Immunology · doi:10.3389/fimmu.2018.00402 · Cited by 34 · see citing works
The Meaning of Immune Reconstitution after Alemtuzumab Therapy in Multiple Sclerosis
Rolla, S., Maglione, A., Mercanti, S. F. D., & Clerico, M. (2020) · Cells · doi:10.3390/cells9061396 · Cited by 36 · see citing works
Treatment of Hemophagocytic Lymphohistiocytosis With Alemtuzumab in Systemic Lupus Erythematosus
Keith, M. P., Pitchford, C. W., & Bernstein, W. B. (2012) · JCR Journal of Clinical Rheumatology · doi:10.1097/rhu.0b013e31824e8d9b · Cited by 34 · see citing works
Immune regulation by CD52-expressing CD4 T cells
Toh, B., Kyaw, T. S., Tipping, P. G., & Bobik, A. (2013) · Cellular and Molecular Immunology · doi:10.1038/cmi.2013.35 · Cited by 34 · see citing works
Autoimmune Thyroid Disease in the Use of Alemtuzumab for Multiple Sclerosis: A Review
Aranha, A. A., Amer, S., Reda, E. S., Broadley, S., & Davoren, P. M. (2013) · Endocrine Practice · doi:10.4158/ep13020.ra · Cited by 34 · see citing works
A remarkable effect of alemtuzumab in a patient suffering from narcolepsy with cataplexy
Donjacour, C. E. H. M., & Lammers, G. J. (2011) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2011.00985.x · Cited by 34 · see citing works
Impact of previous disease-modifying treatment on effectiveness and safety outcomes, among patients with multiple sclerosis treated with alemtuzumab
Pfeuffer, S., Ruck, T., Pul, R., Rolfes, L., Korsukewitz, C., Pawlitzki, M., Wildemann, B., Klotz, L., Kleinschnitz, C., Scalfari, A., et al. (2021) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2020-325304 · Cited by 32 · see citing works
Advancing drug delivery systems for the treatment of multiple sclerosis
Tabansky, I., Messina, M. D., Bangeranye, C., Goldstein, J., Blitz-Shabbir, K. M., Machado, S., Jeganathan, V., Wright, P., Najjar, S., Cao, Y., et al. (2015) · Immunologic Research · doi:10.1007/s12026-015-8719-0 · Cited by 32 · see citing works
Hands on Alemtuzumab-experience from clinical practice: whom and how to treat
Hassoun, L., Eisele, J., Thomas, K., & Ziemssen, T. (2016) · Multiple Sclerosis and Demyelinating Disorders · doi:10.1186/s40893-016-0011-1 · Cited by 31 · see citing works
Serum Thyroid-Stimulating Hormone and Anti-Thyroglobulin Antibody Are Independently Associated with Lesions in Spinal Cord in Central Nervous System Demyelinating Diseases
Long, Y., Zheng, Y., Chen, M., Zhang, B., Gao, C., Shan, F., Yang, N., & Fan, Y. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100672 · Cited by 30 · see citing works
Novel Immunomodulatory Approaches for the Management of Multiple Sclerosis
Kantarci, O. H., Pirko, I., & Rodriguez, M. (2013) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2013.196 · Cited by 26 · see citing works
Anti-T-cell antibodies for the treatment of acute rejection after renal transplantation
van den Hoogen, M. W. F., Hoitsma, A. J., & Hilbrands, L. B. (2012) · Expert Opinion on Biological Therapy · doi:10.1517/14712598.2012.689278 · Cited by 26 · see citing works
Ocular Findings in Alemtuzumab (Campath-1H)-induced Thyroid Eye Disease
Trinh, T., Haridas, A. S., & Sullivan, T. J. (2015) · Ophthalmic Plastic and Reconstructive Surgery · doi:10.1097/iop.0000000000000310 · Cited by 26 · see citing works
Immunotherapy of Multiple Sclerosis
Karussis, D. M. (2013) · BioDrugs · doi:10.1007/s40259-013-0011-z · Cited by 26 · see citing works
Subcutaneous Recombinant Interferon-β-1a (Rebif®)
Sanford, M., & Lyseng-Williamson, K. A. (2011) · Drugs · doi:10.2165/11207540-000000000-00000 · Cited by 25 · see citing works
Immune reconstitution after alemtuzumab therapy for multiple sclerosis triggering Graves’ orbitopathy: a case series
Roos, J. C. P., Moran, C., Chatterjee, K., Jones, J., Coles, A. J., & Murthy, R. (2018) · Eye · doi:10.1038/s41433-018-0282-1 · Cited by 26 · see citing works
Acute respiratory distress syndrome following alemtuzumab therapy for relapsing multiple sclerosis
Keh, R. Y. S., Jackson, F., Sharaf, N., Mihalova, T., Talbot, P. R., Rog, D. J., & Pace, A. (2017) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2017.03.001 · Cited by 24 · see citing works
Similar outcomes of alemtuzumab-based hematopoietic cell transplantation for SAA patients older or younger than 50 years
Sheth, V., Potter, V. T., Gandhi, S., Kulasekararaj, A. G., de Lavallade, H., Muus, P., Pagliuca, A., Rice, C., Mehra, V., Grimaldi, F., et al. (2019) · Blood Advances · doi:10.1182/bloodadvances.2019000480 · Cited by 24 · see citing works
Biological Drugs in Guillain-Barré Syndrome: An Update
Motamed-Gorji, N., Matin, N., Tabatabaie, O., Pavone, P., Romano, C., Falsaperla, R., & Vitaliti, G. (2016) · Current Neuropharmacology · doi:10.2174/1570159x14666161213114904 · Cited by 23 · see citing works
Alemtuzumab Induced Thyroid Disease in Multiple Sclerosis: A Review and Approach to Management
Mahzari, M., Arnaout, A., & Freedman, M. S. (2015) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2015.48 · Cited by 26 · see citing works
Immune Reconstitution Inflammatory Syndrome Associated with Biologic Therapy
Gupta, M., Jafri, K., Sharim, R. R., Silverman, S., Sindher, S., Shahane, A., & Kwan, M. (2014) · Current Allergy and Asthma Reports · doi:10.1007/s11882-014-0499-4 · Cited by 21 · see citing works
Simultaneous early-onset immune thrombocytopenia and autoimmune thyroid disease following alemtuzumab treatment in relapsing-remitting multiple sclerosis
Obermann, M., Ruck, T., Pfeuffer, S., Baum, J., Wiendl, H., & Meuth, S. G. (2016) · Multiple Sclerosis Journal · doi:10.1177/1352458516638558 · Cited by 20 · see citing works
Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients
Rauma, I., Mustonen, T., Seppä, J. M., Ukkonen, M., Männikkö, M., Verkkoniemi‐Ahola, A., Kartau, M., Saarinen, J. T., Luostarinen, L., Simula, S., et al. (2021) · Journal of Neurology · doi:10.1007/s00415-021-10664-w · Cited by 19 · see citing works
Risk Mitigation Strategies for Adverse Reactions Associated with the Disease-Modifying Drugs in Multiple Sclerosis
Subei, A. M., & Ontaneda, D. (2015) · CNS Drugs · doi:10.1007/s40263-015-0277-4 · Cited by 18 · see citing works
Lambert–Eaton myasthenic syndrome associated with alemtuzumab administration
Hoffman, B. M., Zeid, N. E. A., Alam, U., & Caress, J. B. (2018) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2018.10.015 · Cited by 18 · see citing works
Autoimmune thyroid disease following alemtuzumab therapy and hematopoietic cell transplantation in pediatric patients with sickle cell disease
Williams, K. M., Dietzen, D., Hassoun, A. A., Fennoy, I., & Bhatia, M. (2014) · Pediatric Blood & Cancer · doi:10.1002/pbc.25102 · Cited by 18 · see citing works
Development of Autoimmune Thyroid Disease in Multiple Sclerosis Patients Post-Alemtuzumab Improves Treatment Response
Sovetkina, A., Nadir, R., Scalfari, A., Tona, F., Murphy, K. G., Rigoni, E., Dorsey, R., Malik, O., Nandoskar, A., Singh‐Curry, V., et al. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa453 · Cited by 18 · see citing works
Alemtuzumab for the treatment of multiple sclerosis
Willis, M., & Robertson, N. (2015) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s80112 · Cited by 17 · see citing works
Clinical management of multiple sclerosis and neuromyelitis optica with therapeutic monoclonal antibodies: approved therapies and emerging candidates
Dubey, D., Kieseier, B. C., Hartung, H. P., Hemmer, B., Miller-Little, W. A., & Stüve, O. (2014) · Expert Review of Clinical Immunology · doi:10.1586/1744666x.2015.992881 · Cited by 16 · see citing works

PATU7 Autoimmune diseases after alemtuzumab treatment for multiple sclerosis: findings from a multicentre UK cohort
Cossburn, M., Pace, A., Jones, J., Ali, R., Ingram, G., Baker, K., Hirst, C. L., Zajicek, J., Scolding, N. J., Boggild, M., et al. (2010) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2010.226340.36
Autoimmunity and long-term safety and efficacy of alemtuzumab for multiple sclerosis: Benefit/risk following review of trial and post-marketing data
Coles, A. J., Jones, J., Vermersch, P., Traboulsee, A. L., Bass, A. D.-D., Boster, A. L., Chan, A., Comı, G., Fernández, Ó., Giovannoni, G., et al. (2021) · Multiple Sclerosis Journal · doi:10.1177/13524585211061335 · Cited by 27 · see citing works
The role of alemtuzumab in the development of secondary autoimmunity in multiple sclerosis: a systematic review
Sanchez, S. J., Maksoud, R., Eaton-Fitch, N., Marshall‐Gradisnik, S., & Broadley, S. (2024) · Journal of Neuroinflammation · doi:10.1186/s12974-024-03263-9 · Cited by 3 · see citing works
Thyroid autoimmunity following alemtuzumab treatment in multiple sclerosis patients: a prospective study
Kazakou, P., Tzanetakos, D., Vakrakou, A. G., Tzartos, J. S., Evangelopoulos, Μ.-E., Anagnostouli, M. C., Stathopoulos, P., Kassi, G., Stefanis, L., Kilidireas, C., et al. (2023) · Clinical and Experimental Medicine · doi:10.1007/s10238-022-00981-3 · Cited by 17 · see citing works
Risk of Autoimmune Thyroid Dysfunction in Multiple Sclerosis Patients Treated with Alemtuzumab: A Systematic Review
Rashed, N., Adam, T. R., Hamed, N., Hamed, A., Alhaji, Z. M. A., Alharbi, E. A., Alobaid, T. M. A., SAGR, N. A., Abdelbaky, M., & Ahmed, A. A. M. (2026) · Journal of Pioneering Medical Science · doi:10.47310/jpms2025141210

Authors: Cossburn, M., Pace, A. A., Jones, J., Ali, R., Ingram, G., Baker, K., Hirst, C., Zajicek, J., Scolding, N., Boggild, M., Pickersgill, T., Ben-Shlomo, Y., Coles, A., & Robertson, N. P.
Affiliations: University of Cambridge (GB)
From the Department of Psychological Medicine and Neurology (M.C., G.I., K.B., C.H., T.P., N.P.R.), Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK; Department of Neurology (A.A.P., J.Z.), Penninsula Medical School, Tamar Science Park, Derriford, Plymouth; Neurology Unit (J.J., A.C.), Department of Clinical Neurosciences, Cambridge University, Addenbrooke's Hospital, Cambridge; Department of Neurology (R.A., M.B.), The Walton Centre NHS Foundation Trust, Fazakerley,...
ORCID: Pace, A.A.
Jones, J.
Ingram, G.
Hirst, C.
Zajicek, J.
Scolding, N.
Coles, A.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-08-09
Volume: 77
Issue: 6
Pages: 573-579
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.0b013e318228bec5
OpenAlex: W2110867277
Cited by: 216
References: 23
Citations by year: 2026: 4 · 2025: 4 · 2024: 9 · 2023: 11 · 2022: 11 · 2021: 7 · 2020: 10 · 2019: 18 · 2018: 17 · 2017: 16 · 2016: 25 · 2015: 14 · 2014: 19 · 2013: 22 · 2012: 23
FWCI: 15.75
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Explore Bristol Research (publishedVersion)
ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Funders: National Institute for Health and Care Research (CL-2008-14-004)
Topics: Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
Health Sciences › Medicine › Neurology › Autoimmune Neurological Disorders and Treatments
Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
Keywords: alemtuzumab, multiple sclerosis, autoimmune disease, thyroid autoimmunity, smoking, family history (medicine), risk factors, treatment safety
MeSH terms: Alemtuzumab, Adolescent, Adult, Aged, Anti-Inflammatory Agents, Antibodies, Monoclonal, Antibodies, Neoplasm, Antineoplastic Agents, Autoantibodies, Autoimmune Diseases, Counseling, Female, Follow-Up Studies, Humans, Male, Methylprednisolone, Middle Aged, Multiple Sclerosis, Prospective Studies, Risk Factors, Smoking, Thyroid Diseases, Cohort Studies, Treatment Outcome, Young Adult, Antibodies, Monoclonal, Humanized

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Autoimmune disease after alemtuzumab treatment for multiple sclerosis in a multicenter cohort

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks