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May 01, 2018; 90 (18) Clinical/Scientific Notes

Acute coronary syndrome associated with alemtuzumab infusion in multiple sclerosis

Diana Ferraro, Valentina Camera, Francesca Vitetta, Mauro Zennaro, Ludovico Ciolli, Paolo Frigio Nichelli, Patrizia Sola
First published March 30, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005417
Diana Ferraro
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Valentina Camera
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Francesca Vitetta
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Mauro Zennaro
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Ludovico Ciolli
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Paolo Frigio Nichelli
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Patrizia Sola
From the Department of Biomedical, Metabolic and Neurosciences (D.F., V.C., L.C., P.F.N.), University of Modena and Reggio Emilia; and Neurology Unit (F.V., P.S.) and Cardiology Unit (M.Z.), Azienda Ospedaliero-Universitaria di Modena, Italy.
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Acute coronary syndrome associated with alemtuzumab infusion in multiple sclerosis
Diana Ferraro, Valentina Camera, Francesca Vitetta, Mauro Zennaro, Ludovico Ciolli, Paolo Frigio Nichelli, Patrizia Sola
Neurology May 2018, 90 (18) 852-854; DOI: 10.1212/WNL.0000000000005417

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Alemtuzumab is an anti-CD52 monoclonal antibody indicated for the treatment of relapsing-remitting multiple sclerosis (RRMS) with high disease activity despite previous disease-modifying therapies.1 It is administered by IV infusion in a first cycle of 12 mg/d for 5 days (60 mg) and in a second cycle of 12 mg/d for 3 days (36 mg) after 12 months from the first cycle. The most common infusion-associated reaction (IAR), occurring in 90% of alemtuzumab-treated patients, is cytokine-release syndrome, which is managed by premedicating with steroids and treating with symptomatic therapy. Incidence of cardiac-related IARs is 13% (tachycardia, bradycardia, palpitations), of which only 0.7% are serious cardiac-related IARs such as atrial fibrillation, sinus bradycardia, sinus tachycardia, hypotension, or hypertension, and all these events are most frequent on the first day of infusion.2

Footnotes

  • ↵* These authors contributed equally to this work.

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 819

  • See page 827

  • See page 849

  • Received September 17, 2017.
  • Accepted in final form January 19, 2018.
  • © 2018 American Academy of Neurology
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