The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Autoimmune disease after alemtuzumab treatment for multiple sclerosis in a multicenter cohort
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.
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“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 citing paper
“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 the citing paper
“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]
Citations
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Cited by
Sorted by citations
Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies
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“8%, including 1 fatal case that led to a risk mitigation strategy with monthly platelet count monitoring), and Goodpasture syndrome (rare).(98) This secondary autoimmunity may be associated with interleukin 21.”
Reaching an evidence-based prognosis for personalized treatment of multiple sclerosis
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Alemtuzumab in Multiple Sclerosis: Mechanism of Action and Beyond
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“A genetic association between immune thrombocytopenia and MS has also been suggested [70].”
Background
Metadata
- 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,...
- Venue
- Neurology
- Published
- 2011-08-09
- Volume
- 77
- Issue
- 6
- Pages
- 573-579
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- 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 › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Clinical 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
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