title: Anti-CD20 monoclonal antibodies in multiple sclerosis.
abstract: The therapeutic utility of the anti-CD20 monoclonal antibodies (mAbs) is currently being evaluated in multiple sclerosis (MS) in line with the better understanding of the role of B lymphocytes in MS pathogenesis. Area covered: We conducted a literature search using Medline/Pub Med database of basic research and available controlled trials about anti-CD20 mAbs in MS. Additionally, ongoing studies were identified in the ClinicalTrials.gov database. B cells exert multiple inflammatory and regulatory functions playing an important role in MS pathogenesis as is demonstrated by the production of autoantibodies, infiltration of B cells in MS lesions and the formation of ectopic B cell follicle-like structures in meninges, among others. B-cell depletion by anti-CD20 mAbs has been shown to have an impact on these pathogenic mechanisms. The efficacy of three of them, rituximab, ocrelizumab and ofatumumab in MS has been confirmed by placebo-controlled clinical trials demonstrating a significant reduction of the annualized relapsing rate (ARR), new gadolinium-enhancing (GdE) and T2 lesions. There have been no significant safety problems so far but the overall benefit to risk profile is still to be determined. Expert commentary: After recent good results of these agents in MS therapy, questions related to maintenance therapy, markers of response and control of B cells values remain unanswered.
authors.affiliation: a Neuroimmunology unit, Neurology department , Puerta de Hierro-Majadahonda University Hospital , Madrid , Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Moreno Torres
authors.affiliation: a Neuroimmunology unit, Neurology department , Puerta de Hierro-Majadahonda University Hospital , Madrid , Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Merino
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy*; D000069283:Rituximab / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069283:Rituximab; C533411:ocrelizumab; C527517:ofatumumab
keywords: B cells; B lymphocytes; Multiple sclerosis; anti-CD20; meningeal inflammation; monoclonal antibodies; neuroimmunology