Lemtrada (Alemtuzumab) for Multiple Sclerosis

Overview
Lemtrada is a prescription medication approved by the Food and Drug Administration (FDA) for treating people 17 and older with relapsing forms of multiple sclerosis (MS). Lemtrada is also known by its drug name, Alemtuzumab.

Lemtrada is not a cure for MS, but it can decrease the relapse rate and may help reduce the worsening of disability. Due to the risk of serious side effects, Lemtrada is usually only recommended for patients who have not responded well to at least two other MS drugs.

Lemtrada should not be used in people who have Human Immunodeficiency Virus (HIV). Lemtrada should be used with caution in people with a history of thyroid, liver, or kidney problems. Lemtrada is not appropriate for pregnant women, women who might become pregnant, or women who are breastfeeding. People with active infections should not begin taking Lemtrada.

Lemtrada is an immunomodulator, or in other words, a drug that modulates the immune system. It is a genetically engineered antibody, or protein used by the immune system to identify and neutralize substances. Lemtrada is believed to work by reducing the number of lymphocytes, a type of cell involved in autoimmune attacks.

How do I take it?
Lemtrada is taken by intravenous infusion at a medical facility over five days in a row. One year later, you will receive another infusion over three days. You will be monitored for two hours after each infusion.

In order to take Lemtrada, you must be accepted to a restricted program called the Lemtrada REMS Program. REMS, which stands for Risk Evaluation and Mitigation Strategy, is sponsored by the drug’s manufacturer. You will have to answer many questions about your health history that relate to your immune system, and you will undergo a detailed health screening including blood test and urine tests before being accepted.

If you are accepted to the Lemtrada REMS Program, you will go to a medical facility to receive the Lemtrada infusion. You may be required to receive a vaccination for herpes zoster (shingles) before receiving the infusion. You may be prescribed corticosteroids such as Solu-Medrol before receiving the infusion in order to help prevent certain side effects.

Your doctor will order regular blood and urine tests for up to 48 months after your last dose of Lemtrada in order to check for signs of side effects.

Always follow your doctor’s instructions exactly when taking Lemtrada.

Results
The FDA approved Alemtuzumab (Lemtrada) for MS based on two clinical studies. In both two-year studies, people with active relapsing-remitting MS were either given Alemtuzumab or Interferon beta-1a (Rebif). At the end of both studies, participants who were given Alemtuzumab experienced significantly fewer relapses than those who took Interferon beta-1a.

Side effects
Many side effects of Lemtrada can still occur up to 48 months after you take the last dose of Lemtrada.

Rare but serious side effects of Lemtrada include potentially fatal autoimmune disorders of the blood (immune thrombocytopenia) and kidneys (anti-glomerular basement membrane disease). Many people experience infusion reactions while receiving infusions of Lemtrada, and some reactions are severe. People taking Lemtrada may also have an elevated risk of developing cancers such as melanoma, thyroid cancer, and blood cancers.

Common side effects of Lemtrada include fatigue, itching, nausea, vomiting, sore throat, headache, dizziness, insomnia, herpes infection, hives or other skin rashes, fever, cold symptoms, sinusitis, thyroid problems, and pain in the mouth, back, joints, abdomen or extremities. Since Lemtrada lowers your body’s immune system defenses, it can make it easier to contract urinary tract, lung, fungal, and other infections.

Seek medical help immediately if you experience symptoms of an allergic reaction such as trouble breathing, severe dizziness, a rash, or itching or swelling of the face, tongue, and throat.