The Present and Future of Monoclonal Antibody Therapies for Multiple Sclerosis

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.