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Review: Innovative monoclonal antibody therapies in multiple sclerosis

Department of Neurology St. Josef Hospital Ruhr-University Bochum D-44791 Bochum Germany, ralf.linker{at}rub.de

Bernd C. Kieseier

Department of Neurology Heinrich-Heine University Düsseldorf, Düsseldorf Germany

The recent years have witnessed great efforts in establishing new therapeutic options for multiple sclerosis (MS), especially for relapsing—remitting disease courses. In particular, the application of monoclonal antibodies provide innovative approaches allowing for blocking or depleting specific molecular targets, which are of interest in the pathogenesis of MS. While natalizumab received approval by the US Food and Drug Administration and the European Medicines Agency in 2006 as the first monoclonal antibody in MS therapy, rituximab, alemtuzumab, and daclizumab were successfully tested for relapsing-remitting MS in small cohorts in the meantime. Here, we review the data available from these recent phase II trials and at the same time critically discuss possible pitfalls which may be relevant for clinical practice. The results of these studies may not only broaden our therapeutic options in the near future, but also provide new insights into disease pathogenesis.

Key Words: immunotherapy • T-cell • B-cell • blood brain barrier • clinical trial

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