{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T15:15:56Z","timestamp":1789917356158,"version":"4.0.1"},"reference-count":15,"publisher":"Consortium of Multiple Sclerosis Centers","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7,1]]},"abstract":"<jats:p>Background: Alemtuzumab is a humanized monoclonal antibody approved in several countries for treatment of relapsing-remitting multiple sclerosis (RRMS). This report summarizes the experience with infusion-associated reactions (IARs) in two phase 3 trials of alemtuzumab in RRMS and examines skilled nursing interventions in IAR prevention and management.<\/jats:p>\n               <jats:p>Methods: In the Comparison of Alemtuzumab and Rebif\u00ae Efficacy in Multiple Sclerosis (CARE-MS) studies, patients with RRMS (treatment naive [CARE-MS I] or with inadequate response [defined as at least one relapse] to previous therapy [CARE-MS II]) received intravenous infusions of alemtuzumab 12 mg\/day on 5 consecutive days at baseline and on 3 consecutive days 12 months later. Patients were monitored for IARs during and after each infusion. An IAR was defined as any adverse event occurring during any infusion or within 24 hours after infusion.<\/jats:p>\n               <jats:p>Results: The IARs affected 90.1% of patients receiving alemtuzumab. The most common IARs were headache, rash, pyrexia, nausea, and flushing; most were mild to moderate in severity. Management of IARs consisted of infusion interruption or rate reduction, pharmacologic therapies, and continual patient education and support. Medication administration before and during alemtuzumab infusion reduced IAR severity. Forty-five of 972 alemtuzumab-treated patients (4.6%) required interruption of the first treatment course (ie, infusions did not occur on consecutive days); of these, 24 (53.3%) were still able to complete the first and second full treatment courses.<\/jats:p>\n               <jats:p>Conclusions: Nurses played an invaluable role in the detection and management of IARs in the CARE-MS studies. Best practices for management of IARs associated with alemtuzumab include patient and caregiver education, medication to lessen IAR severity, infusion monitoring, and discharge planning.<\/jats:p>","DOI":"10.7224\/1537-2073.2014-030","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T17:54:30Z","timestamp":1421258070000},"page":"191-198","source":"Crossref","is-referenced-by-count":44,"title":["Prevention and Management of Infusion-Associated Reactions in the Comparison of Alemtuzumab and Rebif\u00ae Efficacy in Multiple Sclerosis (CARE-MS) Program"],"prefix":"10.7224","volume":"17","author":[{"given":"Christina","family":"Caon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Namey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Meyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Mayer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Oyuela","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Margolin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Rizzo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4242","reference":[{"key":"2020060300575798600_i1537-2073-17-4-191-b1","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/j.1365-2567.2009.03115.x","article-title":"Investigation of the mechanism of action of alemtuzumab in a human CD52 transgenic mouse model","volume":"128","author":"Hu","year":"2009","journal-title":"Immunology"},{"key":"2020060300575798600_i1537-2073-17-4-191-b2","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1136\/jnnp-2011-300826","article-title":"Long term lymphocyte reconstitution after alemtuzumab treatment of multiple sclerosis","volume":"83","author":"Hill-Cawthorne","year":"2012","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2020060300575798600_i1537-2073-17-4-191-b3","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.1002\/eji.200535075","article-title":"Lymphocyte homeostasis following therapeutic lymphocyte depletion in multiple sclerosis","volume":"35","author":"Cox","year":"2005","journal-title":"Eur J Immunol"},{"key":"2020060300575798600_i1537-2073-17-4-191-b4","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s10875-009-9327-3","article-title":"B-cell reconstitution and BAFF after alemtuzumab (Campath-1H) treatment of multiple sclerosis","volume":"30","author":"Thompson","year":"2010","journal-title":"J Clin Immunol"},{"key":"2020060300575798600_i1537-2073-17-4-191-b5","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1212\/WNL.0b013e31824e8ee7","article-title":"Alemtuzumab more effective than interferon beta-1a at 5-year follow-up of CAMMS223 clinical trial","volume":"78","author":"Coles","year":"2012","journal-title":"Neurology"},{"key":"2020060300575798600_i1537-2073-17-4-191-b6","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1016\/S0140-6736(12)61769-3","article-title":"Alemtuzumab versus interferon beta-1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial","volume":"380","author":"Cohen","year":"2012","journal-title":"Lancet"},{"key":"2020060300575798600_i1537-2073-17-4-191-b7","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/S0140-6736(12)61768-1","article-title":"Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial","volume":"380","author":"Coles","year":"2012","journal-title":"Lancet"},{"key":"2020060300575798600_i1537-2073-17-4-191-b8","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1056\/NEJMoa0802670","article-title":"Alemtuzumab vs. interferon beta-1a in early multiple sclerosis","volume":"359","author":"Coles","year":"2008","journal-title":"N Engl J Med"},{"key":"2020060300575798600_i1537-2073-17-4-191-b9","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/NAN.0b013e3181cfd36d","article-title":"Best practices in multiple sclerosis: infusion reactions versus hypersensitivity associated with biologic therapies","volume":"33","author":"Namey","year":"2010","journal-title":"J Infus Nurs"},{"key":"2020060300575798600_i1537-2073-17-4-191-b10","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1056\/NEJMoa044397","article-title":"A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis","volume":"354","author":"Polman","year":"2006","journal-title":"N Engl J Med"},{"key":"2020060300575798600_i1537-2073-17-4-191-b11","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2165\/11585960-000000000-00000","article-title":"Incidence of infusion-associated reactions with rituximab for treating multiple sclerosis: a retrospective analysis of patients treated at a US centre","volume":"34","author":"Brown","year":"2011","journal-title":"Drug Saf"},{"key":"2020060300575798600_i1537-2073-17-4-191-b12","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.1188\/10.CJON.E10-E21","article-title":"Infusion reactions: diagnosis, assessment, and management","volume":"14","author":"Vogel","year":"2010","journal-title":"Clin J Oncol Nurs"},{"key":"2020060300575798600_i1537-2073-17-4-191-b13","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1634\/theoncologist.2008-0012","article-title":"Managing premedications and the risk for reactions to infusional monoclonal antibody therapy","volume":"13","author":"Chung","year":"2008","journal-title":"Oncologist"},{"key":"2020060300575798600_i1537-2073-17-4-191-b14","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/1531-8249(199909)46:3<296::AID-ANA4>3.0.CO;2-#","article-title":"Monoclonal antibody treatment exposes three mechanisms underlying the clinical course of multiple sclerosis","volume":"46","author":"Coles","year":"1999","journal-title":"Ann Neurol"},{"key":"2020060300575798600_i1537-2073-17-4-191-b15","article-title":"Management of the infusion-associated reactions in RRMS patients treated with LEMTRADA (EMERALD)","author":"ClinicalTrials.gov"}],"container-title":["International Journal of MS Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/ijmsc\/article-pdf\/17\/4\/191\/2116949\/1537-2073_2014-030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/ijmsc\/article-pdf\/17\/4\/191\/2116949\/1537-2073_2014-030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T21:11:48Z","timestamp":1752786708000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijmsc.org\/view\/prevention-and-management-of-infusion-associated-reactions-in-the-comparison-of-alemtuzumab-and-rebif-efficacy-in-multiple-sclerosis-care-ms-program"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,1]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,7,1]]}},"URL":"https:\/\/doi.org\/10.7224\/1537-2073.2014-030","relation":{},"ISSN":["1537-2073"],"issn-type":[{"value":"1537-2073","type":"print"}],"subject":[],"published":{"date-parts":[[2015,7,1]]}}}