Menge Til, Dubey Divyanshu, Warnke Clemens, Hartung Hans-Peter, Stüve Olaf
a Department of Neurology , Heinrich-Heine University Düsseldorf , Düsseldorf , Germany.
b Department of Neurology , LVR-Klinikum Düsseldorf , Düsseldorf , Germany.
Expert Rev Neurother. 2016 Oct;16(10):1131-9. doi: 10.1080/14737175.2016.1227242. Epub 2016 Sep 1.
Despite recent advances in pharmacological management, multiple sclerosis (MS), an autoimmune disease of the central nervous system, remains a leading cause of disability. In relapsing-remitting (RR)MS, neurologists most commonly utilize immunomodulatory or immunosuppressive agents to benefit their patients. With the introduction of humanized monoclonal antibodies (mAbs) ablation of distinct immune populations has become possible. Depletion of B cells by anti-CD20 mAbs has repeatedly proven to be a very rapid and effective means to diminish disease activity in RRMS.
We discuss the biological rationale, development, and recent clinical study results of the second generation anti-CD20 mAb ocrelizumab. Expert commentary: The topline results of two phase-III randomized clinical trials demonstrate superiority of ocrelizumab over interferon beta in RRMS patients with regards to clinical and paraclinical outcome parameters. The short term adverse events profile appears favorable. However, long-term effects of repeated B cell depletion are currently unknown.
尽管在药物治疗方面取得了最新进展，但多发性硬化症（MS）作为一种中枢神经系统自身免疫性疾病，仍然是导致残疾的主要原因。在复发缓解型（RR）MS中，神经科医生最常使用免疫调节或免疫抑制药物来治疗患者。随着人源化单克隆抗体（mAb）的引入，消除特定免疫细胞群成为可能。抗CD20 mAb对B细胞的清除已多次被证明是一种非常快速有效的降低RRMS疾病活动的方法。
我们讨论了第二代抗CD20 mAb奥瑞珠单抗的生物学原理、研发情况及近期临床研究结果。
两项III期随机临床试验的初步结果表明，在RRMS患者中，就临床和临床旁结果参数而言，奥瑞珠单抗优于干扰素β。短期不良事件情况似乎较好。然而，重复B细胞清除的长期影响目前尚不清楚。
