Lemtrada (Alemtuzumab) for Multiple Sclerosis Explained by Neurologist
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- čas přidán 16. 07. 2024
- Timestamps:
00:59 Mechanism of Action
2:55 Treatment Logistics
5:23 Clinical Trial Results
7:37 Long Term Outcomes (TOPAZ Study)
12:21 Side Effects
16:37 Screening Tests
17:38 Safety Monitoring
18:13 Pregnancy/Breastfeeding
I previously ranked Lemtrada as the 2nd most effective disease modifying therapy. This video explains how Lemtrada works and reviews some clinical trial results along with potential side effects.
Selected Sources:
Lemtrada product label: www.accessdata.fda.gov/drugsa...
Pooled analysis of the CARE-MS, extension, and TOPAZ studies: journals.sagepub.com/doi/full...
Immune reconstitution after Lemtrada: www.ncbi.nlm.nih.gov/pmc/arti...
Changes in the immune system subsets after Lemtrada: jneuroinflammation.biomedcent...
Brain atrophy after Lemtrada: www.ncbi.nlm.nih.gov/pmc/arti...
Opportunistic infections with Lemtrada: pubmed.ncbi.nlm.nih.gov/29848...
acquired haemophilia A as complications of alemtuzumab treatment for multiple sclerosis: pubmed.ncbi.nlm.nih.gov/33681...
Comment or ask questions below! I would be happy to answer!
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My book "Resilience in the Face of Multiple Sclerosis" on Amazon: www.amazon.com/dp/B07WP7H5LK
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
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Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: • Video T
he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information. - Věda a technologie
Lemtrada has been a blessing for me. 5 years ago I was headed towards a wheelchair and a EDSS score of 7.5. After my first infusion of Lemtrada I was walking without any assistance devices ie: Cane & walker, at month 3.
I developed hypothyroidism at month 5 round 1. Fast forward I'm relapse free, MRI is clean, stronger than ever before, although the heat reminds me of my disease, EDSS is now 1.5. Lemtrada has given me my life back in all honesty.
EDSS 7.5 > 1.5! Very nice Matt!
Amazing!!! stay strong matt 💪💪💪
Brilliant ❤️
That's awesome brother. I pray God continues to bless you......in the name of Jesus!!
Amazing!!!
Excellent video. Comprehensive and easy to follow. This remains one of my favorite therapeutics in the right patient .
I watched your video twice taking notes then this one video adding to those notes. I'm newly dx'd and will be discussing this with my doctor.
Oh man, oh man, oh man!!!
Wishing this was around 22 years ago when I was diagnosed! Definitely going to ask my neurologist about this on next visit! Thanks!
Very comprehensive video but completely down to earth and easy to understand. After years of what appeared to be mild MS with an occasional relapse and IV steroid treatment, my disease had become pretty aggressive. I was being treated with Copaxone under the care of a General Neuro and because it appeared to be mild he didn't see the need for regular MRI scans. My wife noticed that I was having more and more issues with lower extremity motor fatigue and convinced me to seek out specialized treatment. I was treated by another MS neuro who has a similar CZcams channel and he advised me that Copaxone and I were going to have to go through an abrupt divorce. While my brain MRI scan didn't really seem too remarkable, my spinal MRI was lit up like Clark Griswald's Christmas vacation house. His nurse practitioner even went so far as to say, "I don't know how you are even able to walk". This well dressed Neuro suggested three highly effective DMTs and through his educational videos I was able to make what I felt was the best choice for me. I am now 24 months post round 2 Lemtrada and having no new relapses with unremarkable MRI scans. Lab work shows that my immune system is rebounding as it should and hopefully this trend continues. It is unfortunate that the issues that I am having now isn't from new damage but from the old damage that I was accumulating while my disease was smoldering underneath of Copaxone. In my humble opinion, these videos can be life-changing for the lost looking for answers. keep up the great work.
Sounds scary that u can have completely normal brain MRI but new lesions on spine...my neuro never checked spinal cord (except very first exam) and I'm afraid it may look worse now despite good brain MRI. Btw sounds like your neuro is Aaron Boster, right?
@@luciece I have a few brain lesions but it appears that the my immune system has decided to focus on my spine. Whenever I have annual MRIs, it is always of the brain and the spine. I'm just lucky to live in sunny central Ohio. Take care of yourself.
I just had round 3, I swear it’s the charm. I am so grateful they approved me for round 3.
I'm having great results with Lemtrada, with no new lesions since the first infusion in 2018. I'm even back to long distance running, which I hadn't been able to do for years. It was worth sacrificing my thyroid, because my autoimmune thyroid disease is 100 times easier to live with than the constant MS relapses. Its a high risk, high reward DMT - great for those of us who like to gamble!
Awesome moggiedon. Thanks for sharing.
Thank you for sharing your wonderful news!! Jesus, thank you for watching out for moggiedon. Please continue to bless moggiedon with a good healthy life. Lord Jesus please love, protect and bless moggiedon by showing Your Glory,,,,In the name of jesus.
@@ArmoredDangerousEph6-11 It's the generous and kind taxpayers of the UK who I have to thank for the ongoing miracle of Lemtrada/alemtuzumab. Discovered by government funded scientists, and prescribed and paid for by the National Health Service. Everybody can help do God's work by voting for politicians who support scientific research and healthcare for everybody!!
Did you get hypo or hyperthyroidism?
Thank you, Dr. Beaber, for not minimizing side effects. I bet any person diagnosed with cancer or immediately life-threatening autoimmunes would gladly trade those for MS. These diseases reduce quality of life & life expectancy more severely & rapidly than most MS cases do.
Thank you so much for doing this video Dr Beaber. Lemtrada was the life saver for me, a clinical trial patient on the Care MS CAMMS trial here in Wales, I had been in remission for a whole 12 years until a relapse in 2019 . All those years after being diagnosed I starting off with a year of relapse after relapse and lots disabling symptoms. I had limited use of my arms and legs but since the campath I feel like a different, stronger person! Thanks so much for sharing, I have a love for this treatment, I can't thank it enough and for the kind work that you guys do.
Thanks for the comment Laura. I'm glad you are doing well, and I appreciate your videos as well.
Yes Lemtrada shut my MS down! Phase 3 clinical trial participant. 5 yr post round 2, 2 new lesions, redosed, 5 yr post round 3, new attack. Neuro put me on Ocrevus. This I don’t understand cause I did so well with Lemtrada. I think a fourth round would’ve been good but in the height of pandemic couldn’t see any doctors and having an active attack I just wanted to get something in my system.
So you are one of the very few people who had relapses years after Lemtrada.
Excellent and informative video! Thank you!
I thought many times about having Lemtrada as treatment but I am very scary about the potencial secondary effects :(
Thanks you for the video!
I'm glad you liked it Carla.
It is so amazing, you need it x
Hello Doctor Bieber! I really appreciate you making those videos:) they help a lot in letting me make more guided decisions with my Doctor without having to overthinking too much! You’re great, keep going the content you share is truly valuable for us people with MS.
Question: is there any recent data in 2021 to show a presence of graves a year between the first and second dose of lemtrada (I know my case is really rare but I have been diagnosed with graves in my first year in getting Lemtrada, now my MS and thyroid gland are doing good, not only am I stable but I am looking forward in living my best life with MS!)
Great video!
Thanks
Thank you! That answers the main thing that I was questioning about Lemtrada: whether the possible new auto-immune diseases were permanent or temporary, e.g. until the lymphocytes come back to normal. I understand these are permanent, unfortunately.
One interesting thing my doctor had told me about ITP, if you're unlucky to get it, is that the treatment is often times rituximab. So going full circle in some way.
Thanks for this Dr. Beaber! I am three years post R2. I developed hyperthyroidism about a year ago. After some severe fluctuations with my TSH levels I now take 5mg of methimazole daily. My Lemtrada infusion went very well with no side effects other than insomnia from steroids. I’m grateful my neurologist let me try Lemtrada because I feel like my MS is progressive rather than relapsing. I appreciated the ability to try one of the top medicines to treat it…doing nothing felt hopeless.
How are you doing now? Even I have progressive MS, but I'm scared to try it due to the potential side effects.
@@aditya50499 I have definitely progressed since my Lemtrada treatment but I have no idea if the progression is less than it would have been if I didn’t try it. I am still happy I was able to try something. Ocrevus was not approved in my country when I first started Lemtrada so there were no other options at the time for me for an efficacious DMT. My over active thyroid is basically under control now, however, with all the fluctuations while we were figuring out the correct dosage of medication my hair fell out quite badly. When it grew back in shortly thereafter, it seemed like it came back gray😬. Before this I had a couple gray hairs but now I have a lot.
@@aditya50499 also, I wouldn’t wait until your disability has progressed too much. It’s better to try it early to prevent future disability.
@@cherylvl1036 I'm already an EDSS of 6.5 and can hardly walk any distance even with a walker. I have been on Rituximab for the past 20 months or so. While it has reduced my rate of disability worsening, it is slowly getting worse. Like my EDSS has remained the same since I started Rituximab in December, 2019, but it has now become very difficult to walk, my legs have become quite heavier. I have been exploring other options like cladribine, lemtrada, HSCT,...
@@aditya50499 HSCT looks so promising 🤞🏼
Thank you doc for the in-depth video about this DMT. 👏🏻👏🏻👏🏻👏🏻🙌🏻👍🏻
I'm glad you enjoyed it Mike.
Great video doctor. For a 34yo patient who's recently diagnosed with highly active, rapidly evolving RRMS, and is failing Tysabri, is it a straight toss up between Lemtrada and HSCT? Does Lemtrada work more effectively on highly active patients the way HSCT does? What should be the key points to consider when choosing between the two treatments?
Mr. Beaber, will you make a video just about Tysabri? also i'm thankful for this video. have a nice day, greets from Turkey!
Hi Hasan,
Here is one of many video's on Dr Beaber's channel.
czcams.com/video/ccvGkA_7Kgg/video.html
This is probably the video you are looking for Hasan: czcams.com/video/LIKPYQFVNCQ/video.html
nice video !
Thanks Robin
Congrats! Great video ! #AttackMS
Best ever!! Started in February/2019, round 2 in February/2020, in march covid came... starting physiotherapy this month to walk again with no aid !!
What do you think about low dose anti CD20 as maintenence and prevention of other autoimmunity reactions?
People have talked about using medications like rituximab or azathioprine to reduce secondary autoimmune diseases, but I have not seen any specific data on it. It would be a very logical approach, but I think people would be reluctant to take additional immunosuppressants.
Dear Dr. Beaber,
regarding the 1st Graph: Following the 3rd month period where Rebif and Lemtrada had not yet shown a difference, the graph ABRUPTLY shows a big difference, however difference did not increase too much from there on. Does this suggest that if it is going to help at all the positive effect will typically reveal itself within the first 6 months.
Is the first 6 months usuallya good indicator with strong DMT's?
I started my first of the 2 half nfusions of Ocrevus®for PPMS on Jan 12 2023, but so far it has only sped up my EDSS , I'm leaning to discontinuing .
IS IT TOO EARLY TO ASSESS?
Also, I plan for RUIZ HSCT hopefully within a year so maybe I should consider an early wash out?
Currently on Ocrevus, since 2018. What considerations need to be considered before switching to Lemtrada?
Thank you for a nice presentation. Do you think it is a good idea to give low dose Rituximab following Lemtrada to better regulate B cells and minimize the risk of 2ndery autoimmune disease?
Same question!! I'm on Rituximab and repopulate very slowly. 5 months post 500mg of Rituximab, my B cells are still at 0.04%. I wonder if I would be on a safer side than many if I get Lemtrada as my next treatment.
Hi Dr. Bieber, could you share your thoughts on using Kesimpta in months 6-11 (potentially less, but definitely 6 -7 maybe), to encourage prior T cell formation before the B cells return? If I’m understanding correctly, it seems to be thought that the potential cause of secondary autoimmune problems arise because the B cells develop first. Could you please share your thoughts??
Idioma imenso interested in doing this, do you know if there is a clinical study in Rio de janeiro?
Why isn't this prescribed for PPMS?
I had a cavity on a top molar tooth(unbeknownst to me) and ravaged me for years. It started with ear eczema.... then years later head and shoulders stopped working and I ended up getting MS like symptoms..... this sucks. Teeth are very important. I only knew I had a bad tooth when I started using interdental brushes.... because a piece of my tooth fell off 😱. I was written off as my unprovoked panic attacks and headaches( as in no triggers) were seen as Psychosomatic... 😩
No same problem via an upper molar that broke, infection spread, damaged my vestibular system. Problem is: When I see my everyday doctors, they attribute the balance problems to MS, and not the Confluence of Two Separate Problems. Well Said.
Would you consider lemtrada as a DMT for a first therapy for somebody newly dx’d with multiple sclerosis?
Sure
Sir, as with Lemtrada, there is a risk of developing secondary autoimmunity as the B cells tend to repopulate faster than T cells, does Cladribine/ Mavenclad, considering it also depletes both B and T lymphocytes, also carry such a risk?
Kind regards.
As far as I know, this is not thought to be a major risk with mavenclad. The problem with lemtrada is that the b-cells replete faster without regulatory t-cells present.
@@DrBrandonBeaber thank you sir for taking time out to reply. Much appreciated!
كيف احصل ع هاي الابراء
Unfortunately, Lemtrada hasn’t been good to me. I had an MS attack with five new lesions after the second dose and have been diagnosed with cervical dysplasia just recently.
God bless Dr okouromi for healing me of Herpes
Are every secondary autoimmune conditions related to Lemtrada treatable if caught early?
Yes. Many of them are treatable (even serious secondary autoimmune diseases such as idiopathic thrombocytopenic purpura), but sometimes people require long-term treatment after thyroiditis with thyroid replacement (synthroid)
@@DrBrandonBeaber So treatable are also secondary autoimmune disease against kidney or liver with good prognosis (these are fortunately rare) ? If yes, it is good.
Lemtrada for PPMS!?
I think people should consider Autologous Stem Cell Therapy between cycles, wouldn't it be like HSCT ? haha
Is age a contraindication to Lemtrada?
Not specifically, although the risks of infection would likely be higher for an older person with more medical comorbidities.
🇹🇷🇹🇷🇹🇷👍
God bless Dr okouromi for healing me of Herpes.
Cool! What treatment this Dr. prescribed?
@@freethinkeralways pure natural herbal medicine, and it works perfectly well.
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@@benstallion3476 contact Dr okouromi directly on WhatsApp.,....