A case series study has determined that it is safe to use the multiple sclerosis medication Lemtrada (alemtuzumab) during the COVID-19 pandemic.
The study was done because alemtuzumab is an immunosuppressive drug. The study aimed to determine whether the drug’s immunosuppressive properties made it more likely for people taking the drug to be infected with COVID-19 or suffer more severe symptoms from the disease.
“These findings, although very preliminary, may suggest that patients treated with alemtuzumab did not show a higher risk of COVID-19 infection or greater severity. Likewise, patients with MS and alemtuzumab seemed to show milder and shorter forms of COVID-19 in comparison to their relatives,” the study states.
Some studies have shown that treatment which produces lymphocyte depletion may actually result in milder COVID-19 disease, and this study seemed to provide further evidence pointing towards this trend.
“Likewise, patients with MS and alemtuzumab seemed to show milder and shorter forms of COVID-19 in comparison to their relatives. Alemtuzumab produces a lymphocyte reconstitution of the immune system, with the development of a new generation of lymphocytes from a new lineage (Hartung et al., 2015), starting with regulatory T-cells, but with a relevant role of memory lymphocytes. Perhaps the lymphocyte reconstitution induced by alemtuzumab, including changes in composition, phenotype, and function of lymphocytes, may confer a potential resistance of this new lineage to the virus or avoiding the cytokine storm associated with life- threatening complications such as cardiac dysfunction, respiratory failure, and coagulopathy (Liu et al., 2020).” the study states.
The study notes its own limitations, including its limited sample size. The case series study involved “ten patients treated with alemtuzumab at the onset of the pandemic.” Another limitation the study notes is the fact that no patients recently treated with alemtuzumab were infected.
“Larger and multicenter studies would be necessary to confirm these findings and to evaluate the safety of patients receiving alemtuzumab during the pandemic,” the study states regarding its limitations.
“In conclusion, our study suggests that alemtuzumab seems to be safe in the context of the COVID-19 pandemic. Furthermore, we speculate whether alemtuzumab may even be a therapeutic option for the COVID- 19 infection itself, given the mechanism of action generating a recon- stituted immune system more resistant to the virus and reducing the risk of the cytokine storm. Further research is necessary to confirm our findings,” the study concludes.
Alemtuzumab usage has been associated with serious side effects including arterial dissection, hemorrhagic stroke and ischemic stroke.