Abstract
In recent years, there has been a significant increase in the therapeutic options available for the management of relapsing forms of MS. Therapies primarily targeting B cells, including therapeutic anti-CD20 monoclonal antibodies, have been evaluated in phase I, phase II, and phase III clinical trials. Results of these trials have shown their efficacy and relatively tolerable adverse effect profiles, suggesting a favorable benefit-to-risk ratio. In this review, we discuss the pathogenic role of B cells in MS and the rationale behind the utilization of B-cell depletion as a therapeutic cellular option. We also discuss the data of clinical trials for anti-CD20 antibodies in relapsing forms of MS and existing evidence for other B-cell–directed therapeutic strategies.
GLOSSARY
- ADCC=
- antibody-dependent cell-mediated cytotoxicity;
- APRIL=
- a proliferation-inducing ligand;
- APC=
- antigen-presenting cell;
- CDC=
- complement-dependent cytotoxicity;
- DC=
- dendritic cell;
- DMT=
- disease-modifying therapy;
- Ig=
- immunoglobulin;
- OCB=
- oligoclonal band;
- OCB=
- ocrelizumab;
- OFT=
- ofatumumab;
- PML=
- progressive multifocal leukoencephalopathy;
- PPMS=
- primary progressive MS;
- RA=
- rheumatoid arthritis;
- RTX=
- rituximab;
- SLE=
- systemic lupus erythematosus;
- SPMS=
- secondary progressive MS
Footnotes
Funding information and disclosures are provided at the end of the article. Go to Neurology.org/nn for full disclosure forms. The Article Processing Charge was funded by the authors.
- Received May 11, 2017.
- Accepted in final form July 13, 2017.
- Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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