Blood pressure changes during alemtuzumab infusion for multiple sclerosis patients.

Abstract

Blood pressure (BP) changes during alemtuzumab infusions are poorly understood. The aim of this study was to examine BP changes during alemtuzumab infusions in persons with multiple sclerosis (PwMS). This was a retrospective cohort review of systolic (S) and diastolic (D) BP in PwMS receiving alemtuzumab. Thirty-one patients were identified; 22 (64.5%) were women. Mean age and disease duration were 35.2±7.1 and 9.2±5.4years, respectively. There was no history of hypertension or vascular events. Mean baseline SBP was 119.8±15.1mmHg, 118.8±14.3mmHg and 106.5±6.1mmHg whilst mean DBP was 75.3±9.2mmHg, 74.1±12.4mmHg and 69.2±4.3mmHg at doses 1, 6 and 9, respectively. During the first cycle, SBP increased by 19.2±9.4mmHg, with comparable percentage increases over the five infusions (16%, 22%, 17%, 11%, 13%, respectively). DBP increased by 6.2±3.8mmHg with similar percentage increases over the five infusions (8.4%, 11.5%, 5.5%, 7%, 3%). For the second cycle, SBP increased by 16.9±3.2mmHg, with similar increases over the 3days (12%, 15%, 17%). DBP increased by 5.4±4.2mmHg (11%, 9%, 12.8%). The third cycle demonstrated increased mean and percentage of SBP and DBP by 8.9±2.3mmHg (10%, 70%, 11.8%) and 4.2±1.9mmHg (3%, 2%, 6.5%), respectively. Collectively, for 31 patients, in the first cycle, mean SBP increased from 119.8±15.1mmHg to 138.8±13mmHg (p˂0.001), whilst mean DBP increased from 74.5±9.2mmHg to 79.2±9.1mmHg (p=0.007). Overall, 17 (54.8%) patients had increasing BP by ≥20% and nine (29%) had increasing BP by ≥20mmHg from baseline. This demonstrates significant increases in BP during alemtuzumab infusions in PwMS.