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Interview with Dr. Alastair Compston on alemtuzumab therapy in MS

Dr. Compston interview

Dr. Timothy Vartanian, Director of the Judith Jaffe Multiple Sclerosis Center interviews Dr. Allistair Compston, Professor of Clinical Neuroscience, Cambridge University.

The details of the early development of alemtuzumab (Campath-H1) and subsequent clinical trials are discussed. Campath-H1 was the first humanized monoclonal antibody and was developed to deplete lymphocytes. First tested in patients with vasculitis, but was not an effective treatment in these patients. Alemtuzumab was first tested in patients with progressive MS, but alemtuzumab was not effective in this cohort. However, the researchers discovered that the treatment stopped disease activity. Further discussion on the mechanism of actions of the compound in MS are also discussed.

The study design and result of CAMMS223 and other clinical trials were also discussed. This was an impressive phase II study that showed that alemtuzumab was more effective than interferon beta-1a in patients with early, relapsing–remitting multiple sclerosis. However, there were some safety concerns including autoimmunity.

Imaging studies have shown a reduction of new lesions after treatment with alemtuzumab. Alemtuzumab protects against tissue damage, perhaps by preventing new lesion formation.

Given the risk of certain adverse events with alemtuzumab there are risk management strategies for alemtuzumab in place. Patient selection is also important given the risks associated with alemtuzumab; therefore, this agent is approved for use in the US in patients with relapse-remitting MS that have not responded to two or more other therapies.