Incidence, management, and outcomes of autoimmune nephropathies following alemtuzumab treatment in patients with multiple sclerosis
| Autor: | Daniel Wynn, David Margolin, Richard G Phelps, Glen S. Markowitz, Alasdair Coles, Mario Habek, Claudio E Rodriguez, Darren P Baker, Hans-Peter Hartung, Jonathan A. Winston, Eva Havrdova |
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| Přispěvatelé: | Habek, Mario [0000-0002-3360-1748], Apollo - University of Cambridge Repository |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Lung Diseases Male medicine.medical_specialty Membranous glomerulonephropathy Hemorrhage Anti-Glomerular Basement Membrane Disease multiple sclerosis Gastroenterology Glomerulonephritis Membranous Nephropathy 03 medical and health sciences 0302 clinical medicine Glomerulonephritis Multiple Sclerosis Relapsing-Remitting Internal medicine medicine Humans Immunologic Factors In patient 030212 general & internal medicine Alemtuzumab anti-glomerular basement membrane disease business.industry Multiple sclerosis Incidence (epidemiology) Incidence medicine.disease disease-modifying therapy Editorial Neurology nephropathy membranous glomerulonephropathy Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug Follow-Up Studies |
| Zdroj: | Multiple Sclerosis (Houndmills, Basingstoke, England) Phelps, R, Winston, J A, Wynn, D, Habek, M, Hartung, H-P, Havrdová, E K, Markowitz, G S, Margolin, D H, Rodriguez, C E, Baker, D P & Coles, A J 2019, ' Incidence, management, and outcomes of autoimmune nephropathies following alemtuzumab treatment in patients with multiple sclerosis ', Multiple Sclerosis Journal, pp. 1352458519841829 . https://doi.org/10.1177/1352458519841829 |
| ISSN: | 1477-0970 |
| DOI: | 10.1177/1352458519841829 |
| Popis: | Background: Autoimmune disorders including nephropathies have been reported more frequently in alemtuzumab-treated multiple sclerosis (MS) patients than in the general population. Objective: Describe instances of autoimmune nephropathy in alemtuzumab-treated MS patients. Methods: Cases were identified from safety monitoring within the alemtuzumab relapsing-remitting multiple sclerosis (RRMS) clinical development program (CDP) or post-marketing, or following off-label use. Results: As of 16 June 2017, 16 autoimmune nephropathies have occurred following alemtuzumab treatment for MS. The incidence of autoimmune nephropathies was 0.34% within the CDP (5/1485 patients). The five CDP cases (one of anti-glomerular basement membrane (anti-GBM) disease, two of membranous glomerulonephropathy, and two of serum anti-GBM antibody without typical anti-GBM disease) were identified early, responded to conventional therapy (where needed), and had favorable outcomes. Three of 11 cases outside the CDP occurred following off-label alemtuzumab use prior to approval for RRMS and were all anti-GBM disease. Diagnosis was delayed in one of these three cases and another did not receive appropriate treatment; all three cases resulted in end-stage renal failure. All anti-GBM disease cases with documented urinalysis demonstrated prior microscopic hematuria. Conclusion: Close monitoring of alemtuzumab-treated MS patients facilitates diagnosis and treatment early in the nephropathy course when preservation of renal function is more likely. |
| Databáze: | OpenAIRE |
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