MS- Alemtuzumab DI

Question 1

Alemtuzumab brand name

Answer 1

Lemtrada

Question 2

Lemtrada indications

Answer 2

RRMS, SPMS

Question 3

When is Lemtrada used?

Answer 3

Generally reserved for inadequate response to ≥2 meds

Question 4

Lemtrada MoA

Answer 4

Targets CD52 on T and.B lymphocytes, NK cells, macrophages and monocytes –> causing long-term reduction of circulating T-cells

Question 5

Lemtrada dosing

Answer 5

12mg IV infusion QD over 4 houes x5 days, then a 3-day course at month 12

3-day dose can be repeated for another 3 days after 12 months

Question 6

What should patients be pretreated with before Lemtrada dosing?

Answer 6

Corticosteroids, antihistamines, and/or antipyretics, antiviral prophy

Question 7

Lemtrada ADEs

Answer 7

DEVELOPMENT OF AUTOIMMUNE THYROID DISORDERS

Rash, HA, pyrexia, fatigue, pruritus, urticaria, N/V/D, neurologic problems, paresthesia, dizziness, chills, insomnia, chest discomfort/dysgeusia, dyspnea, nasopharyngitis, musculoskeletal pain/discomfort, dyspepsia, flushing, UTI, sinusitis, URI, fungal infections

Question 8

Lemtrada monitoring

Answer 8

TSH for the autoimmune thyroud disorders
CBC with diff
SCr
Urinalysis
Signs and symptoms of infection
Post-dose observation for 2 hours
ECG
No live vaccines
HPV screening
PML
Skin exams

Question 9

Lemtrada BBWs

Answer 9

Immune thrombocytopenia and anti-glomerular basement membrane disease, infusion reactions, malignancy (melanoma, thyroid cancer)