Extended dosing of monoclonal antibodies in multiple sclerosis

Mult Scler. 2022 Nov;28(13):2001-2009. doi: 10.1177/13524585211065711. Epub 2021 Dec 24.

Abstract

Over the past two decades, treatment options for patients with multiple sclerosis (MS) have increased exponentially. In the current therapeutic landscape, "no evidence of MS disease activity" is within reach in many of our patients. Minimizing risks of complications, improving treatment convenience, and decreasing health care costs are goals that are yet to be reached. One way to optimize MS therapy is to implement personalized or extended interval dosing. Monoclonal antibodies are suitable candidates for personalized dosing (by therapeutic drug monitoring) or extended interval dosing. An increasing number of studies are performed and underway reporting on altered dosing intervals of anti-α4β1-integrin treatment (natalizumab) and anti-CD20 treatment (ocrelizumab, rituximab, and ofatumumab) in MS. In this review, current available evidence regarding personalized and extended interval dosing of monoclonal antibodies in MS is discussed with recommendations for future research and clinical practice.

Keywords: Multiple sclerosis; extended dosing; monoclonal antibodies; personalized dosing.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents, Immunological*
  • Humans
  • Integrins / therapeutic use
  • Multiple Sclerosis* / drug therapy
  • Natalizumab / therapeutic use
  • Rituximab / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Integrins
  • Natalizumab
  • Rituximab