[Updated recommendations of the Council of Experts on the use and safety of alemtuzumab (Lemtrada)]

Alemtuzumab (Lemtrada) is a recombinant humanized IgG1 kappa monoclonal antibody to the surface cell glycoprotein, a CD52 differentiation cluster. The drug is approved for use in more than 65 countries, including the Russian Federation. The drug is one of the most effective methods of treating patients with aggressive multiple sclerosis, but the risk management plan should be followed. The safety profile of the drug includes infusion-associated reactions, thyroid dysfunction, immune cytopenia, acute cardiovascular events, infections, and other autoimmune diseases. This publication provides updated practical recommendations for the use of the drug and ensuring the safety of patients treated with alemtuzumab.

[An additional analysis of the efficacy and safety of therapy in the Russian population of patients with multiple sclerosis participated in phase III international multicenter clinical trials: results of alemtuzumab study]

The article is discussing the data of additional analyses of subpopulation of MS patients from Russia, participating in phase III clinical trials of DMTs (article by E.P. Evdoshenko et al in this issue). This review the data of alemtuzumab trials CARE-MS I and CARE-MS II with special attention to Russian patients. Such statistics allows to find new peculiarities of the drug effectiveness, selection of groups of patients, showing better results in MS patients with high disease activity, but low residual disability. Data of longitudinal observations are of special interest. Presented data on the 8-years observation of MS after alemtuzumab therapy show low annual relapse rate (mean 0,14-0,18) and stable disability levels, even with confimed disability improvement of EDSS in 41-47% of patients.

Clinical recommendations for the use of ocrelizumab in patients with multiple sclerosis

The paper presents a detailed algorithm for the treatment and follow-up of patients with recurrent multiple sclerosis and primary progressive multiple sclerosis in the use of ocrelizumab.

[Provision of alemtuzumab safety is one of the main components of pharmacovigilance]

Modern multiple sclerosis therapy with disease-modifying drugs is characterized by the risks of dangerous infectious complications. In the last 5 years, there have been several reports of severe, sometimes lethal, listeriosis infection in patients treated with alemtuzumab. This article presents a clinical case of lethal listeriosis meningoencephalitis, which developed within 7 days after the completion of the first cycle of alemtuzumab therapy. In January 2018, a meeting of the expert Council was held, at which the clinical recommendations published in 2017 were revised and updated.