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Alemtuzumab side effects: what 19,229 FDA adverse event reports show

Alemtuzumab · Lemtrada · 1,227 reaction terms · 109,106 drug–reaction co-reports · data 2026-09-14
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Drug class

CD52-directed Cytolytic Antibody

FDA label (Established Pharmacologic Class)

Brand names

Lemtrada

openFDA label

Who reports

19,229 reports · 86% serious · 2,921 with death outcome · 59% female

openFDA FAERS counts, all years, deduplication not applied

Used for

LEMTRADA is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include relapsing-remitting disease and active secondary progressive disease, in adults. Because of its safety profile, the use of LEMTRADA should generally be reserved for patients who have had an inadequate response to two or more drugs indicated for the treatment of MS .

FDA label, Indications and Usage

What it is

Alemtuzumab is a recombinant humanized IgG1 kappa monoclonal antibody directed against the cell surface glycoprotein, CD52. Alemtuzumab has an approximate molecular weight of 150 kD. Alemtuzumab is produced in mammalian cell (Chinese hamster ovary) suspension culture in a nutrient medium containing neomycin.

FDA label, Description section

Boxed warning

AUTOIMMUNITY, INFUSION REACTIONS, STROKE, AND MALIGNANCIES LEMTRADA causes serious, sometimes fatal, autoimmune conditions such as immune thrombocytopenia and anti-glomerular basement membrane disease. Monitor comple.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 3Labeled (related wording) 5Reporting / coding artifact 1Lab value / disease marker 19Not in label — unassessed 12
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,187 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Actinomycotic sepsis182,764.7
1,154.9–6,618.6ROR 2,767.3 · χ² 13,160 / p <1e-300
424.2 EB05 283.9 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=18not reported in cached trials
Specific gravity urine decreased71954.2
693.4–1,313.1ROR 957.8 · χ² 35,315 / p <1e-300
445.1 EB05 364.8 · IC025 +6.4
3/3 methods agree
Lab value / disease markerserious n=71 · ♀ 87% (drug 59%)not reported in cached trials
Haemoglobin urine present80705.0
532.0–934.4ROR 708.0 · χ² 33,544 / p <1e-300
386.7 EB05 320.6 · IC025 +6.5
3/3 methods agree
Lab value / disease markerserious n=76 · ♀ 92% (drug 59%)not reported in cached trials
Bacterial test111648.6
512.7–820.5ROR 652.4 · χ² 44,365 / p <1e-300
378.4 EB05 323.0 · IC025 +6.9
3/3 methods agree
Reporting / coding artifactserious n=109 · ♀ 88% (drug 59%)NCT00930553: 1/1,314 (0.1%) on Alemtuzumab (serious AE)
Urine leukocyte esterase22639.3
377.2–1,083.4ROR 640.0 · χ² 8,396 / p <1e-300
297.5 EB05 207.1 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=21 · ♀ 100% (drug 59%)not reported in cached trials
T-cell prolymphocytic leukaemia33601.4
392.8–920.6ROR 602.4 · χ² 12,302 / p <1e-300
315.4 EB05 235.0 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=33 · 100% cliniciannot reported in cached trials
Crystal urine present187549.3
460.9–654.8ROR 554.7 · χ² 67,381 / p <1e-300
350.8 EB05 310.6 · IC025 +7.3
3/3 methods agree
Lab value / disease markerserious n=182 · ♀ 80% (drug 59%)not reported in cached trials
Mucoepidermoid carcinoma of salivary gland19537.6
310.0–932.3ROR 538.1 · χ² 6,431 / p <1e-300
263.7 EB05 178.4 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Specific gravity urine increased44525.6
366.6–753.6ROR 526.8 · χ² 15,124 / p <1e-300
306.3 EB05 237.6 · IC025 +5.7
3/3 methods agree
Lab value / disease markerserious n=43not reported in cached trials
Urinary sediment present201500.3
423.4–591.0ROR 505.5 · χ² 68,010 / p <1e-300
330.9 EB05 294.3 · IC025 +7.3
3/3 methods agree
Lab value / disease markerserious n=196 · ♀ 94% (drug 59%)not reported in cached trials
Urine leukocyte esterase positive218487.3
415.5–571.5ROR 492.9 · χ² 72,468 / p <1e-300
326.0 EB05 291.3 · IC025 +7.3
3/3 methods agree
Lab value / disease markerserious n=213 · ♀ 88% (drug 59%)not reported in cached trials
Bilirubin urine present34468.7
313.4–700.9ROR 469.5 · χ² 10,726 / p <1e-300
276.0 EB05 206.6 · IC025 +5.3
3/3 methods agree
Lab value / disease markerserious n=34not reported in cached trials
Urobilinogen urine increased46430.1
305.6–605.2ROR 431.1 · χ² 13,760 / p <1e-300
272.7 EB05 212.7 · IC025 +5.7
3/3 methods agree
Lab value / disease markerserious n=46 · ♀ 85% (drug 59%)not reported in cached trials
Nitrite urine present113378.5
305.6–468.8ROR 380.7 · χ² 31,188 / p <1e-300
267.5 EB05 228.6 · IC025 +6.7
3/3 methods agree
Lab value / disease markerserious n=109 · ♀ 85% (drug 59%)not reported in cached trials
Pyelonephritis fungal18358.4
210.3–610.9ROR 358.7 · χ² 4,547 / p <1e-300
209.5 EB05 140.2 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=18not reported in cached trials
Red blood cells urine positive235350.0
302.3–405.2ROR 354.3 · χ² 61,430 / p <1e-300
258.7 EB05 232.1 · IC025 +7.2
3/3 methods agree
Lab value / disease markerserious n=229 · ♀ 83% (drug 59%)not reported in cached trials
Band neutrophil percentage increased24322.6
204.4–508.9ROR 323.0 · χ² 5,673 / p <1e-300
207.5 EB05 146.8 · IC025 +4.7
3/3 methods agree
Lab value / disease markerserious n=24 · 100% cliniciannot reported in cached trials
Ph urine increased36291.0
201.4–420.5ROR 291.6 · χ² 7,962 / p <1e-300
204.5 EB05 154.3 · IC025 +5.2
3/3 methods agree
Lab value / disease markerserious n=35NCT00930553: 1/1,314 (0.1%) on Alemtuzumab (serious AE)
Autoimmune thyroid disorder23290.9
183.6–461.1ROR 291.3 · χ² 5,004 / p <1e-300
192.7 EB05 135.3 · IC025 +4.6
3/3 methods agree
Labeled adverse reaction
exact term
serious n=23 · ♀ 100% (drug 59%)NCT02255656: 1/1,062 (0.1%) on Alemtuzumab (serious AE)
Adenovirus reactivation29288.7
191.7–434.9ROR 289.1 · χ² 6,330 / p <1e-300
198.2 EB05 144.7 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=28 · 100% cliniciannot reported in cached trials
Autoimmune pancytopenia17272.8
160.2–464.4ROR 273.0 · χ² 3,458 / p <1e-300
175.3 EB05 115.9 · IC025 +4.1
3/3 methods agree
Labeled adverse reaction
exact term
serious n=17NCT00930553: 1/1,314 (0.1%) on Alemtuzumab (serious AE)
Perineal ulceration26254.1
165.8–389.6ROR 254.5 · χ² 5,099 / p <1e-300
178.9 EB05 128.3 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=26 · 100% cliniciannot reported in cached trials
Lymphocyte percentage decreased249247.7
215.9–284.0ROR 250.9 · χ² 49,521 / p <1e-300
198.4 EB05 178.6 · IC025 +7.0
3/3 methods agree
Lab value / disease markerserious n=242not reported in cached trials
Microsporidia infection64239.8
182.9–314.3ROR 240.6 · χ² 12,248 / p <1e-300
185.4 EB05 150.3 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=64 · ♀ 0% (drug 59%) · 100% cliniciannot reported in cached trials
Monocyte percentage increased118218.7
179.6–266.5ROR 220.1 · χ² 21,072 / p <1e-300
176.8 EB05 151.6 · IC025 +6.4
3/3 methods agree
Lab value / disease markerserious n=116not reported in cached trials
Neutrophil percentage increased209215.7
186.0–250.0ROR 218.0 · χ² 37,018 / p <1e-300
176.9 EB05 157.7 · IC025 +6.7
3/3 methods agree
Lab value / disease markerserious n=203not reported in cached trials
White blood cells urine positive290200.6
177.1–227.3ROR 203.7 · χ² 48,384 / p <1e-300
167.4 EB05 151.8 · IC025 +6.8
3/3 methods agree
Lab value / disease markerserious n=283 · ♀ 89% (drug 59%)not reported in cached trials
Tri-iodothyronine free increased26191.5
126.2–290.5ROR 191.7 · χ² 4,021 / p <1e-300
145.5 EB05 104.3 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=26 · ♀ 100% (drug 59%)not reported in cached trials
Cd4 lymphocytes abnormal31188.3
128.6–275.7ROR 188.6 · χ² 4,757 / p <1e-300
146.1 EB05 107.8 · IC025 +4.9
3/3 methods agree
Lab value / disease markerserious n=22not reported in cached trials
Autoimmune neutropenia40173.4
124.2–242.1ROR 173.8 · χ² 5,757 / p <1e-300
139.6 EB05 107.0 · IC025 +5.2
3/3 methods agree
Labeled adverse reaction
exact term
serious n=40 · 100% cliniciannot reported in cached trials
Red cell distribution width decreased63171.9
131.8–224.2ROR 172.5 · χ² 9,083 / p <1e-300
142.0 EB05 115.0 · IC025 +5.7
3/3 methods agree
Lab value / disease markerserious n=62 · ♀ 100% (drug 59%)not reported in cached trials
Chronic graft versus host disease in intestine25169.1
110.9–257.7ROR 169.3 · χ² 3,465 / p <1e-300
131.7 EB05 93.8 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=25 · 100% cliniciannot reported in cached trials
Gastroenteritis adenovirus21168.5
106.4–266.9ROR 168.7 · χ² 2,880 / p <1e-300
129.0 EB05 89.0 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=21not reported in cached trials
Urinary casts51164.7
122.7–221.0ROR 165.1 · χ² 7,053 / p <1e-300
135.8 EB05 107.3 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=49 · ♀ 81% (drug 59%)not reported in cached trials
Monocyte percentage decreased24164.4
107.0–252.5ROR 164.6 · χ² 3,240 / p <1e-300
128.4 EB05 90.8 · IC025 +4.5
3/3 methods agree
Lab value / disease markerserious n=23 · ♀ 100% (drug 59%)not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Alemtuzumab as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (6 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Headache1,8973.3
3.2–3.5ROR 3.6 · χ² 3,142 / p <1e-300
3.3 EB05 3.2 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.0 · ♀ 80% (drug 59%)NCT00930553: 7/1,314 (0.5%) on Alemtuzumab (serious AE)
Fatigue (tiredness)1,8672.6
2.5–2.7ROR 2.8 · χ² 1,944 / p <1e-300
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.9NCT00930553: 1/1,314 (0.1%) on Alemtuzumab (serious AE)
Pyrexia (fever)1,7765.6
5.4–5.9ROR 6.1 · χ² 6,815 / p <1e-300
5.6 EB05 5.4 · IC025 +2.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.4NCT00930553: 2/1,314 (0.2%) on Alemtuzumab (serious AE)
Off label use (used outside approved label)1,6742.1
2.0–2.2ROR 2.2 · χ² 1,011 / p 4e-222
2.1 EB05 2.0 · IC025 +1.0
3/3 methods agree
Reporting / coding artifactserious PRR 2.4 · 93% cliniciannot reported in cached trials
Rash1,1933.0
2.8–3.2ROR 3.1 · χ² 1,624 / p <1e-300
3.0 EB05 2.9 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.8NCT00930553: 1/1,314 (0.1%) on Alemtuzumab (serious AE)
Nausea1,1851.6
1.6–1.7ROR 1.7 · χ² 306 / p 1e-68
1.6 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 2.0 · ♀ 80% (drug 59%)NCT00930553: 7/1,314 (0.5%) on Alemtuzumab (serious AE)
Drug ineffective (drug did not work)1,0160.8
0.8–0.9ROR 0.8 · χ² 32 / p 7e-9
0.8 EB05 0.8 · IC025 -0.4
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 1.5not reported in cached trials
Dyspnoea (shortness of breath)9841.9
1.8–2.0ROR 1.9 · χ² 429 / p 2e-95
1.9 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 1.6NCT00930553: 3/1,314 (0.2%) on Alemtuzumab (serious AE)
Asthenia (weakness)9392.7
2.6–2.9ROR 2.8 · χ² 1,042 / p 7e-229
2.7 EB05 2.6 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.4not reported in cached trials
Lymphocyte count decreased87856.9
53.3–60.9ROR 59.6 · χ² 45,817 / p <1e-300
54.1 EB05 51.1 · IC025 +5.6
3/3 methods agree
Lab value / disease markerserious PRR 42.3NCT02255656: 2/1,062 (0.2%) on Alemtuzumab (serious AE)
Cytomegalovirus infection84058.0
54.2–62.1ROR 60.6 · χ² 44,615 / p <1e-300
55.0 EB05 52.0 · IC025 +5.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 37.2 · 96% cliniciannot reported in cached trials
Urinary tract infection (bladder infection)8235.3
5.0–5.7ROR 5.5 · χ² 2,875 / p <1e-300
5.3 EB05 5.0 · IC025 +2.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.3 · ♀ 81% (drug 59%)NCT00930553: 1/1,314 (0.1%) on Alemtuzumab (serious AE)
Pain7531.3
1.2–1.4ROR 1.3 · χ² 65 / p 4e-16
1.3 EB05 1.3 · IC025 +0.3Labeled adverse reaction
exact term
serious PRR 1.2NCT00930553: 11/1,314 (0.8%) on Alemtuzumab (serious AE)
Condition aggravated7212.6
2.4–2.8ROR 2.7 · χ² 722 / p 3e-159
2.6 EB05 2.4 · IC025 +1.3
3/3 methods agree
Reporting / coding artifactserious PRR 2.5not reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Alemtuzumab?

In FDA FAERS, the most frequently co-reported reaction terms for Alemtuzumab are headache, fatigue, pyrexia, rash, nausea, dyspnoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Alemtuzumab have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: AUTOIMMUNITY, INFUSION REACTIONS, STROKE, AND MALIGNANCIES LEMTRADA causes serious, sometimes fatal, autoimmune conditions such as immune thrombocytopenia and anti-glomerular basement membrane disease. Monitor comple.

Do FAERS signals prove that Alemtuzumab causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.