News for alemtuzumabers

Prof G what can be done to manage my hyperthyroidism if I want to fall pregnant? Carbimazole is associated with an increased risk of congenital malformations, especially when administered in the first trimester of pregnancy and at high doses. Women of childbearing potential should use effective contraception during treatment with carbimazole. Carbimazole: increased risk of congenital...

NEDADI or ‘Nee Daddy’ another treatment target beyond NEDA

Prof G do you think disability improvement is a reasonable treatment goal? NEDADI = no evident disease activity and disability improvement Two weeks ago one of my patients with PPMS, who we treated with off-label subcutaneous cladribine, came for her annual follow-up appointment. Despite being treated with cladribine over 2 years ago she has unfortunately progressed from EDSS 5.5 to 6.5. Her...

Beyond NEDA

Prof G are we being lulled into a false sense of security by being told that we have no evident disease activity (NEDA)? A patient of mine, who I have been looking after now for over 11 years, asked me in clinic a few weeks ago why despite being NEDA for 6 years, on a highly effective maintenance DMT (fingolimod), has she gone from being able to run 5-10 km to needing a stick and barely managing...

Should we be ignored, disproved or whitewashed? Autoimmunity after alemtuzumab

Last year we suggested that a problem with alemtuzumab was that it failed to adequately deplete immature B cells in the bone marrow. These cells rapidly re-populate the body after depletion and this leads to a hyper-repopulation of B cells. Importantly, and different from ocrelizumab and cladribine, which both deplete B cells, this occurs after alemtuzumab in the relative absence of T cell...



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