Rheumatoid arthritis Campath

Pruzanski, W., Urowitz, M. B., Grouix, B., and Vadas, P. (1995). Induction of TNF-alpha and proinflammatory secretory phospholipase A2 by intravenous administration of CAMPATH-1H in patients with rheumatoid arthritis. /. Rheumatol. 22, 1816-1819. 

Alemtuzumab (campath-lH) is a humanized monoclonal antibody specific for the CDw52 antigen, present on cell membranes of lymphocytes and monocytes. It has been used for treatment of patients with rheumatoid arthritis and vasculitis, is being investigated for the treatment of chronic lymphocytic leukemia, and has been used to deplete circulating lymphocytes in patients with multiple sclerosis (1). In 2001, alemtuzumab was approved in Europe for the treatment of chronic B cell lymphocytic leukemia that had been treated previously with alkylating agents and was refractory to fludarabine (2). It has also been used for induction of immunosuppression/tolerance in liver transplant recipients (3,4) and kidney/pancreas transplant recipients (5). 

However, follow-up of patients with rheumatoid arthritis treated with the depleting pan-lymphocyte mAb Campath-1 suggests this view may be over-cautious (11). Infective complications were observed only in the first few months after mAb administration and responded to conventional treatment. Infections such as reactivation of Herpes zoster showed normal distribution over one or two dermatomes rather than the widespread involvement which one might have expected if patients were over-immunosuppressed. Malignancy has not been observed at a hi er frequency than one would expect for this group despite... 

Brett SJ, Baxter G, Cooper H, Rowan W, Regan T, Tite J, Rapson N. Emergence of CD52-, glycosylphosphatidylinositol-anchor-deficient lymphocytes in rheumatoid arthritis patients following Campath-IH treatment. Intemat Immunol 1996 8 325-334. 

---