What are some monoclonal antibody treatments in development for MS?
At present, several additional monoclonal antibodies are being studied as investigational treatments for MS. They are not currently available for routine use in the treatment of MS.
Rituximab (Rituxan®) is a monoclonal antibody directed at B-cells (CD20+ B-cells) and have been reported recently to be efficacious in treatment of relapsing-remitting MS. Studies in primary progressive MS did not produce statistically significant results. This drug is FDA approved for treatment of rheumatoid arthritis and non-Hodgkin’s lymphoma. (Read more about Rituxan in Rituximab Infusion: My First Experience)
[Note: I believe that ofatumumab, a fully human monoclonal antibody focused on CD20+ B-cells, will replace rituximab in studies in MS. See listing in clinicaltrials.gov.]
Alemtuzumab (Campath®) is another monoclonal antibody directed at lymphocytes (CD52+ B-cells) which is under continued investigation for treatment in MS. Campath was found to be more effective than Rebif in early relapsing-remitting MS. Both rituximab and alemtuzumab are associated with longer-term immunosuppression (6 to 12 months). Serious immunological and infectious complications have occurred with these agents.
Daclizumab (Zenapax®) is FDA approved for the treatment of kidney transplant rejection. Zenapax is a humanized monoclonal therapy which targets CD25+ T-cells and blocks IL-2. It is off-label for MS and people with relapsing-remitting and transitional MS are treated with this agent. Most often these people have failed several other treatments. Efficacy has been demonstrated in off-label experience, two small phase II studies, and a larger multi-center phase II study. Currently, a longer duration multi-center phase II trial is in progress in Europe. Rash, fever, and occasional overgrowth of lymph nodes have been observed in people on long-term therapy with this drug.
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Monoclonal Antibodies: Treatments in Development for MS