Table 1.

Monoclonal antibodies currently on the market or being evaluated in phase II/III studies.

	Therapeutic Monoclonal Antibodies
MAB	Composition	Target	Mechanism of Action	Administration	FDA Approval Date for MS
Alemtuzumab	Humanized MAB IgGk	CD52	ADCC	Intravenous	November 2014
Elezanumab [11]	Fully human MAB	RGMa	Binds and neutralizes RGMa which modulates T cell responses and dendritic cells in CNS lesions	Intravenous	N/A
GNbAC1 [12]	Humanized IgG4 MAB	Envelope protein of HERV-W MSRV	Targets the envelope protein of HERV-W MSRV, which may play a critical role in multiple sclerosis	Intravenous	N/A
Natalizumab	Humanized monoclonal IgG1	Cell adhesion molecule α4-integrin	Preventing lymphocyte transport across the blood brain barrier	Intravenous	November 2004 and reapproved on June 2006
Ocrelizumab	Humanized IgG1	Phosphorylated glycoprotein CD20 on B lymphocytes	ADCC > CDC	Intravenous	March 2017
Ofatumumab	Fully humanized IgG1	CD20	CDC > ADCC	Subcutaneous	N/A
Opicinumab	Humanized MAB	Targets LINGO-1	Allows OPCs to differentiate into mature OLG for remyelination	Intravenous	N/A
Ublituximab	Chimeric IgG1 MAB	CD20	CDC and ADCC	Intravenous	N/A
Rituximab	Chimeric (murine/human) MAB	CD20	CDC and ADCC	Intravenous	N/A
VAY736 [13]	Defucosylated, human IgG1 MAB	Targets the receptor for BAFF-R	ADCC and blockade of BAFF:BAFF-R signaling that drives B cell differentiation, proliferation and survival	Intravenous	N/A

Abbreviations: monoclonal antibody (MAB), multiple sclerosis (MS), not applicable (N/A), envelope protein (Env), human endogenous multiple sclerosis-associated retrovirus (HERV-W MSRV), cluster of differentiation (CD), complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC), T helper (Th), Leucine-rich repeat and immunoglobulin domain-containing neurite outgrowth inhibitor receptor-interacting protein 1 (LINGO-1), oligodendrocyte precursor cells (OPCs), oligodendrocytes (OLGs), repulsive guidance molecule A (RGMa), B cell activating factor of the TNF family (BAFF-R).