Treating multiple sclerosis with monoclonal antibodies: the cons.

The clinical use of monoclonal antibodies (MAbs) in multiple sclerosis (MS) is an exciting clinical prospect whose current use is subject to several limitations. Clinical studies to date have shown that infusion of murine MAbs, the preparations presently available, is associated with the production of antimurine antibody, which makes the long-term use of this therapy infeasible in most patients. This is a considerable drawback in a chronic progressive disease such as MS, where retreatment options are an important consideration in choice of therapy. In addition, most murine MAbs are not lytic for targeted cells. The target antigens often undergo modulation and the cells reappear in the circulation with full function in spite of ongoing therapy. The use of MAbs in MS needs further clarification through randomized, controlled clinical trials.