Monoclonal antibodies - a revolutionary therapy in multiple sclerosis

Introduction. Multiple sclerosis (MS) has an increasing incidence and affects a young segment of the population, having a major impact on patients and consequently on society. The multifactorial aetiology and pathogenesis of this disease are incompletely known at present, but autoimmune aggression has a documented mechanism. State of the art. Since the 19905, immunomodulatory drugs of high efficacy and a good safety profile have been launched. But the concept of NEDA (No Evidence of Disease Activity) remains the target to achieve. Thus, the new revolutionary class of monoclonal antibodies (moAbs) used in multiple medical fields, from this perspective represents a challenge even for multiple sclerosis, including the primary progressive form, for which there has been no treatment until recently. Clinical implications. In this article, we will review monoclonal antibodies' use for MS, presenting their advantages and disadvantages, based on data accumulated since 2004 when the first monoclonal antibody was approved for active forms of the disease. Future directions. There is still a need for personalised medicines, with a specific target, which should have fewer adverse effects and drug interactions.