Adverse events and monitoring requirements associated with monoclonal antibody therapy in patients with multiple sclerosis

Abstract

Multiple sclerosis (MS) is treated with a variety of immunomodulatory and immunosuppressive drugs. Among the most potent therapeutic options are monoclonal antibodies (MAbs). So far, the MAbs natalizumab, alemtuzumab, and ocrelizumab have been approved for MS treatment. While their efficacy is indisputable, these drugs have safety issues not seen with previous MS drugs. MAbs are the ideal class of treatment for many patients with MS, but neurologists prescribing these MAbs need to be aware of their potential risks and monitor patients closely. Although rare, adverse events associated with MAbs may be fatal; opportunistic infections, tumors, and infusion-related events require planning and monitoring of patients before, during, and after MAb therapy. This review summarizes the type and management of adverse events associated with MAb treatment in patients with MS, and emphasizes the importance of evidence-based knowledge for all neurologists involved in MS therapy.