New biological agents in the treatment of multiple sclerosis

Bratisl Lek Listy. 2018;119(4):191-197. doi: 10.4149/BLL_2018_035.

Abstract

Multiple sclerosis (MS) is an inflammatory disease induced by autoimmune processes. Their understanding has resulted in an introduction of biological agents to its treatment. Interferon beta and glatiramer acetate have been in clinical practice for more than 20 years. Nowadays, novel biologics, which target molecules involved in immunopathological processes more specifically have entered the scene. They are represented by monoclonal antibodies binding to molecules VLA4 (natalizumab), CD20 (ocrelizumab), CD52 (alemtuzumab) or alpha subunit of IL-2 receptor (daclizumab) or by small molecules such as those modulating the receptors involved in regulation of lymphocyte migration (fingolimod, ozanimod) or in induction of lymphopenia by apoptosis (dimethyl fumarate, cladribine). In the article, we shortly describe their efficacies, adverse reactions and perspectives of a future development in MS biologics. A treatment of neuromyelitis optica by monoclonal antibodies (rituximab, aquaporumab) is given too (Tab. 1, Fig. 2, Ref. 71).

Keywords: JC virus; PML IRIS.; migration of T and B cells; monoclonal antibodies; multiple sclerosis; neuromyelitis optica.

Publication types

  • Review

MeSH terms

  • Alemtuzumab / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products / therapeutic use*
  • Cladribine / therapeutic use
  • Daclizumab
  • Dimethyl Fumarate / therapeutic use
  • Fingolimod Hydrochloride / therapeutic use
  • Humans
  • Immunoglobulin G / therapeutic use
  • Immunologic Factors / therapeutic use
  • Immunosuppressive Agents / therapeutic use*
  • Indans / therapeutic use
  • Multiple Sclerosis / drug therapy*
  • Natalizumab / therapeutic use
  • Neuromyelitis Optica / drug therapy*
  • Oxadiazoles / therapeutic use
  • Rituximab / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Immunoglobulin G
  • Immunologic Factors
  • Immunosuppressive Agents
  • Indans
  • Natalizumab
  • Oxadiazoles
  • Alemtuzumab
  • Cladribine
  • Rituximab
  • ocrelizumab
  • Daclizumab
  • Dimethyl Fumarate
  • Fingolimod Hydrochloride
  • ozanimod