049 Hypertension is uncommon during alemtuzumab treatment for relapsing-remit- ting multiple sclerosis

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Background Haemorrhagic cerebrovascular events have been reported during Alemtuzumab treatment for relapsing-remitting multiple sclerosis (RRMS) leading to changes in the marketing authorisation in Europe. Hypertension is the proposed mechanism. Aims To characterise systolic blood pressure (SBP) changes during Alemtuzumab administration and the frequency of significant hypertension. Method We recorded SBP measurements during Alemtuzumab infusions from a random sample of RRMS patients. Mean SBP changes were calculated for each day and the 5-day treatment course. Common Terminology Criteria for Adverse Events was used to grade hypertension. Results 2412 SBP measurements from 50 RRMS patients (mean age 35.9 years; 70% female) were recorded. No patients had premorbid hypertension. The mean (SD) SBP change was -0.7 (7.59) mmHg over 5 days. Two (4%) patients developed sustained grade III hypertension (SBP ≥160mmHg) over two or more readings >15 minutes apart, which resolved spontaneously. No patients had immediate cerebrovascular complications. Conclusions Clinically-significant hypertension is uncommon during Alemtuzumab treatment and should prompt close clinical observation. Slowing (or stopping) the rate of infusion should be considered in patients with sustained hypertension. hui.chingong@nhs.net

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