Monoclonal Antibodies for Multiple Sclerosis: An Update.

The use of monoclonal antibodies in multiple sclerosis (MS) patients is in a transitional period. Studies regarding well-established, effective antibodies such as natalizumab and alemtuzumab focus more and more on long-term efficacy and safety, risk management, and treating complications. Primary progressive MS, a disease that was long considered to be unmodifiable, is currently in focus following ocrelizumab being approved as the first drug with a proven beneficial effect on the disease course. Conversely, post-marketing safety mechanisms have also proven to function as daclizumab has been suspended after a series of relevant serious adverse events. Currently, new therapies are emerging that promise more convenience and an improved safety profile (ofatumumab) or remyelinating potential with clinical improvement (opicinumab). While it is very unlikely that monoclonal antibodies will ever cure MS, they have become very valuable therapeutic tools to better patient outcomes. This review focuses on developments of monoclonal antibodies used in the past, present, and near future in MS patients.