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Review
. 2025 Nov;39(6):815-826.
doi: 10.1007/s40259-025-00741-1. Epub 2025 Sep 23.

The Present and Future of Monoclonal Antibody Therapies for Multiple Sclerosis

Silvia Susin-Calle  1   2 , Elvira Munteis  1   2 , Pablo Villoslada  3   4 , Jose E Martinez-Rodriguez  1   2
Affiliations
Review

The Present and Future of Monoclonal Antibody Therapies for Multiple Sclerosis

Silvia Susin-Calle et al. BioDrugs. 2025 Nov.

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by inflammation, demyelination, and neurodegeneration. Advances in understanding MS immunopathogenesis have led to the development of monoclonal antibodies (MABs) that target key immune pathways, providing highly selective and effective treatment options. Approved MABs, including those against CD20, CD25, CD52, and α4‑integrin, have demonstrated robust efficacy in reducing relapse rates, suppressing MRI activity, and, to some extent, slowing disability progression. Meanwhile, emerging agents aim to modulate neuroinflammation, promote remyelination, and improve safety profiles. This review summarizes the mechanisms of action, clinical efficacy, safety, and future perspectives of MAB therapies in MS, highlighting lessons from discontinued agents and opportunities for next‑generation therapeutics.

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Conflict of interest statement

Declarations. Funding: No funding was involved in the preparation of the article. Conflicts of interest: SSC has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the article. She has received travel expenses from Merck. EM has received travel support from Novartis, Merck, and BMS. PV holds stocks or stock options and has received consultancy fees, from Bionure and Oculis, Spiral Therapeutics, Attune Neurociences, Adhera Health, Accure Therapeutics, QMENTA, Clarity Health technologies, Telara Pharma SL, Nimbus Therapeutics, and CLight. JEMR has participated as principal investigator in pharmaceutical company-sponsored clinical trials, including Novartis, Roche, Merck-Serono, Actelion, and Celgene, and received personal fees for consulting services and lectures from Novartis, Biogen-Idec, Sanofi, and Merck-Serono. Availability of data and material: Available from the authors upon request. Ethics approval: This review did not require ethics review or approval. Consent to participate: There were no participants. Consent for publication: There were no participants. Code availability: There was no code in this article. Author contributions: SS: conceptualization, literature review, drawing illustrations, and drafting the article. EM: conceptualization and manuscript review. PV: conceptualization and manuscript review. JEM-R: conceptualization and manuscript review.

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