Effectiveness And Safety Of Alemtuzumab For Multiple Sclerosis:a Systematic ReVIEW

Objective To explore the efficacy and safety of alemtuzumab in the treatment of patients with multiple sclerosis.Methods The Cochrane Library, Medline and EMBASE database were searched for relevant studies. Eligible studies were clinical trials of multiple sclerosis assigned to alemtuzumab versus placebo or other treatments with data on efficacy including the relapse rate, the sustained accumulation of disability rate, and active MRI lesions. Risk of bias was evaluated to assess the quality of the studies. The overall datas was calculated using a random-effects or fixed-effects model, depending on the heterogeneity of the included trials. We also checked references in identified trials and manually searched the reports (2004to February2014) from neurological associations and MS societies.Results A total of3clinical trials including1755people evaluated the efficacy and safety of alemtuzumab versus placebo for adult patients with MS. The Meta-analyses showed that:a) significant decrease of the relapse rate[OR=0.45,95%CI(0.36,0.57), P<0.01] and the sustained accumulation of disability rate[OR=0.55,95%CI(0.40,0.76), P<0.01]; b) alemtuzumab had benefits on reducing the cumulative number of gadolinium-enhancing lesions[OR=0.33,95%CI(0.23,0.48), P<0.01]; c) the incidence of adverse events is the same with placebo.Conclusions Alemtuzumab was effective and safe for patients with MS, but RCTs with high methodological quality and longer periods of observation are needed to assess its efficacy and safety.