A Comprehensive Review of Anti-CD20 Monoclonal Antibodies in Multiple Sclerosis

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Multiple sclerosis (MS) poses a complex challenge that affects countless individuals worldwide. The multifaceted pathogenesis of this disease has stymied researchers and clinicians. However, advances have been made in understanding its immunological roots, leading to novel therapies such as anti-CD20 monoclonal antibodies (mAbs) that target B cells. These mAbs offer a precise approach to immune modulation, holding the potential to arrest disease progression and reduce relapses. This review delves into the efficacy, mechanisms, and safety of anti-CD20 mAbs in the treatment of MS. Clinical trials have consistently demonstrated their efficacy in reducing relapse rates, slowing the progression of disability, and improving patients' quality of life. While concerns about infections remain, safety data support their viability. Comparative analysis of mAbs such as rituximab, ocrelizumab, ofatumumab, and ublituximab unveils their unique mechanisms and dosing regimens. For long-term success, treatment optimization is paramount, balancing sustained disease control with safety monitoring, personalization, and quality of life considerations. Combining mAbs with existing or emerging therapies shows promise. Looking ahead, precision medicine, cellular therapies, and digital health technologies promise to revolutionize MS care. This review equips clinicians, researchers, and stakeholders with a comprehensive understanding of the anti-CD20 mAbs potential in MS management and envisions an era of tailored therapies and innovation in MS treatment.