particularly in treatment modifications of anxiolytics and sedatives.This study suggests that pharmacists may find it difficult to achieve anticholinergic burden reductions by suggesting AD changes to physicians and patients.

95% CI. Monotherapy Pb reserves platinum doublet for later use, and additional data for OS in the pemetrexed subgroup is needed for addressing the benefit of the combination. Taking into account the toxicity of adding chemotherapy, the combined regimen should be considered cautiously.

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post-treatment (NRPT). Data were collected from medical records and the electronic prescription programme. Effectiveness was evaluated in terms of NRPT with alemtuzumab. Safety was assessed by reported treatment of AE. Results Eleven patients, 63.6% women, mean age 38 (24-54) years, were included. Median time from RRMS diagnosis was 10 (4-20) years and mean baseline EDSS was 3.5 (2-5.5). Patients were previously treated with a median of 3 (2-4) drugs: interferon beta-1a (IFNb-1a) intramuscularly (45.5%), IFNb-1a subcutaneously (27.3%), glatiramer acetate (27.3%), natalizumab (90.9%), fingolimod (27.3%) and dimethyl fumarate (18.2%). Seven patients completed two courses of alemtuzumab, and the second course is pending in three patients. One administration was suspended due to an infusion related reaction (IRR), requiring intensive care. The mean relapse rate was 0.36 (0-2). All patients experienced IRRs: lymphopenia (63.6%) and skin disorders (72.7%). Most were mild and limited in time, except for one patient with skin rash, pruritus and oedema, requiring discontinuation of treatment. Other AE were urinary tract infection (18.2%) and herpes zoster infections (9.1%). Conclusion and relevance According to our results, alemtuzumab was effective in clinical practice due to a low relapse rate. However, further studies with a larger number of patients are needed to confirm these results. IRRs were frequent. Nevertheless, AE were mild and well tolerated.

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