Table 1.

Summary of New and Emerging Monoclonal Therapies.

Therapy	Mechanism of Action	Administration	Significant Adverse Events	Side Effects
Alemtuzumab	Humanized monoclonal antibody targeting CD52 Induces rapid depletion of T and B cells	Initial IV infusion for 5 consecutive days, followed by annual IV infusions for 3 consecutive days*	Auto-immune disease: Thyroid disease, Immune Thrombocytopenic Purpura, Goodpasture’s Disease	Infusion reactions Upper respiratory tract infections
Daclizumab	Humanized monoclonal antibody targeting CD25 Immune modulator of T cells	IM injection once monthly*	Possible auto-immune hepatitis	Cutaneous rash Infections (UTI, URI, nasopharyngitis, no opportunistic infections) Elevated liver enzymes
Ocrelizumab	Humanized monoclonal antibody targeting CD20 B cell suppression	IV infusion*	Systemic Inflammatory Response Syndrome	Infusion reactions Infection (no opportunistic infections in MS trial experience)
Ofatumumab	Humanized monoclonal antibody targeting CD20 B cell suppression	IV infusion*	Insufficient data	Infusion reactions Infection (no opportunistic infections in MS trial experience)
Natalizumab	Humanized monoclonal antibody VLA-4 antagonist	300 mg IV infusion once every 4 weeks	PML Hypersensitivity reactions Hepatotoxicity	Infusion reactions Headache Fatigue

^*Optimal dose under investigation,

Abbreviations: IV, intravenous; PML, progressive multifocal leukoencephalopathy; UTI, urinary tract infection; URI, upper respiratory infection.