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Treating primary-progressive multiple sclerosis: potential of ocrelizumab and review of B-cell therapies

Authors Feng JJ, Ontaneda D

Received 27 October 2016

Accepted for publication 23 December 2016

Published 1 February 2017 Volume 2017:7 Pages 31—45

DOI https://doi.org/10.2147/DNND.S100096

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Thomas Müller

Jenny J Feng,1 Daniel Ontaneda2

1Department of Neurology, 2Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA

Abstract: Multiple sclerosis (MS) therapy has evolved rapidly with an increased availability of several immunomodulating therapies over the past two decades. Disease-modifying therapies have proven to be effective in treating relapse–remitting MS (RRMS). However, clinical trials involving some of the same agents for secondary-progressive and primary-progressive MS (SPMS and PPMS) have been largely negative. The pathogenesis of progressive MS remains unclear, but B-cells may play a significant role in chronic compartmentalized inflammation, likely contributing to disease progression. Biologics targeted at B-cells, such as rituximab, are effective in treating RRMS. Ocrelizumab is a humanized monoclonal antibody to CD20+ B-cells that has shown positive results in PPMS with a significant reduction in disease progression. This review aims to discuss in detail the involvement of B-cells in MS pathogenesis, current progress of currently available and investigational biologics, with focus on ocrelizumab, and future prospects for B-cell therapy in PPMS.

Keywords: Ocrelizumab, primary progressive multiple sclerosis, B-cells

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