Strategies to treat and prevent the development of neutralizing anti-interferon-β antibodies

Up to 35% of people with multiple sclerosis (MS) treated with interferon-beta (IFNbeta) develop neutralizing anti-IFNbeta antibodies within 2 years of starting therapy. These antibodies reduce or abolish the biologic effects and clinical efficacy of IFNbeta. The overall efficacy of IFNbeta and hence the cost-effectiveness of this treatment would be substantially improved if the development of neutralizing antibodies (NAbs) could be prevented or reversed. Strategies used to prevent or reverse the development of NAbs with other biologic compounds, including improvements in the manufacturing process, immunosuppression, induction of tolerance, and deimmunization, will be reviewed.