Evidence map›Paper›PMID 39487492›Full record

SynthesisJournal of neuroinflammation2024

The role of alemtuzumab in the development of secondary autoimmunity in multiple Sclerosis: a systematic review.

Sofia Jimenez-Sanchez, Rebekah Maksoud, Natalie Eaton-Fitch, Sonya Marshall-Gradisnik, Simon A Broadley

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of neuroinflammation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sofia Jimenez-SanchezSchool of Medicine and Dentistry, Gold Coast Campus, Griffith University, Southport, QLD, Australia. s.jimenezsanchez@griffith.edu.au.
Rebekah MaksoudNational Centre for Neuroimmunology and Emerging Diseases, Griffith University, Southport, QLD, Australia.
Natalie Eaton-FitchNational Centre for Neuroimmunology and Emerging Diseases, Griffith University, Southport, QLD, Australia.
Sonya Marshall-GradisnikNational Centre for Neuroimmunology and Emerging Diseases, Griffith University, Southport, QLD, Australia.
Simon A BroadleySchool of Medicine and Dentistry, Gold Coast Campus, Griffith University, Southport, QLD, Australia.

Funding

Multiple Sclerosis Australia 21-2-060Multiple Sclerosis Australia 22-3-052
6 · The paper itself

Abstract

backgroundSecondary autoimmune disease (SAID) in the context of alemtuzumab treatment is one of the main safety concerns that may arise following administration in people with multiple sclerosis (pwMS). Contributing factors underlying this adverse event are not well understood. The purpose of this systematic review was to appraise the literature investigating the role of alemtuzumab in the development of SAID in pwMS following treatment and identify potential biomarkers/ risk factors that may be predictive of onset of this manifestation.

methodsRelevant publications were retrieved from PubMed, Embase, and Web of Science using a three-pronged search strategy containing the following keywords: "multiple sclerosis"; "alemtuzumab"; and "autoimmunity". Studies that fulfilled the specified eligibility criteria and investigated SAID development after alemtuzumab in pwMS were included in the final analysis.

results19 papers were included in the final review. Approximately, 47.92% of pwMS treated with alemtuzumab experienced SAID. A variety of biomarkers and risk factors were noted in the development of SAID, with a focus on immunological changes, including: increased homeostatic proliferation and T cell cycling, along with consistently elevated baseline serum IL-21 levels and thyroid autoantibodies. There was no significant association between known human leukocyte antigen (HLA) risk alleles, lymphocyte profile or dynamics and SAID development.

conclusionsWhile the mechanism underlying SAID following alemtuzumab is not fully understood, potential biomarkers and risk factors that may assist in elucidating mechanisms underlying this phenomenon have been documented in several independent studies. Following immunodepletion from alemtuzumab, an IL-21 driven increase in homeostatic proliferation and T cell cycling may disrupt tolerance mechanisms leading to an increase in the propensity toward alemtuzumab-induced autoimmunity. Further research is necessary to clarify the physiological changes after alemtuzumab therapy that trigger SAID in pwMS.

Indexed as

AlemtuzumabMultiple SclerosisAutoimmune DiseasesAutoimmunityHumansImmunologic FactorsAlemtuzumabImmunologic FactorsAlemtuzumabMultiple SclerosisSecondary autoimmune disease

Identifiers

PMID39487492
PMCPMC11528992

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.