Treating multiple sclerosis with monoclonal antibodies: a 2013 update

Abstract

The third part of this in-depth review series on the treatment of multiple sclerosis (MS) with monoclonal antibodies covers the years 2010–2012. The natalizumab section gives a progressive multifocal leukoencephalopathy update, focusing on clinically relevant aspects. Furthermore, it outlines problems around natalizumab cessation and current evidence on therapeutic strategies thereafter. Finally, it reviews evidence on Janus-faced modes of natalizumab action besides anti-inflammatory effects, including proinflammatory effects. The section on alemtuzumab critically analyzes recent Phase III results and discusses which patients might be best suited for alemtuzumab treatment, and reviews the long-term immunological impact of this anti-CD52 antibody. The daclizumab section critically summarizes results from the Phase IIb SELECT/SELECTION trial and introduces the Phase III program. The section on anti-CD20 antibodies reviews Phase II results on ocrelizumab and ofatumumab, and discusses current perspectives of these antibodies for MS therapy. Promising recent Phase II results on the anti-IL-17A antibody secukinumab (AIN457) are outlined and a short update on tabalumab (LY2127399) is given. Other highlighted antibodies currently being tested in MS patients include GNbAC1, BIIB033, MOR103 and MEDI-551. Finally, the authors give an update on the role monoclonal antibodies could play in the therapeutic armamentarium for MS in the medium term.

Keywords::

• alemtuzumab
• BIIB033
• daclizumab
• GNbAC1
• LY2127399
• MEDI-551
• MOR103
• natalizumab
• ocrelizumab
• ofatumumab
• rituximab
• tabalumab

Financial & competing interests disclosure

A Deiß has received travel grants from Biogen Idec and Teva Pharmaceuticals. I Brecht has received a travel grant from Merck Serono. A Haarmann has received a travel grant from Biogen Idec. M Buttmann has received travel grants from Biogen Idec; he has also served on an advisory board and received travel grants and a research grant from Merck Serono; he has served on an advisory board for Almirall Hermal GmbH; he has received research grants from Novartis; and he has received research grants from Sanofi-Aventis and Teva Pharmaceutical Industries Ltd., as well as from the Interdisciplinary Center for Clinical Research (IZKF) at the University of Würzburg. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.