The therapeutic utility of the anti-CD20 monoclonal antibodies (mAbs) is 
currently being evaluated in multiple sclerosis (MS) in line with the better 
understanding of the role of B lymphocytes in MS pathogenesis. Area covered: We 
conducted a literature search using Medline/Pub Med database of basic research 
and available controlled trials about anti-CD20 mAbs in MS. Additionally, 
ongoing studies were identified in the ClinicalTrials.gov database. B cells 
exert multiple inflammatory and regulatory functions playing an important role 
in MS pathogenesis as is demonstrated by the production of autoantibodies, 
infiltration of B cells in MS lesions and the formation of ectopic B cell 
follicle-like structures in meninges, among others. B-cell depletion by 
anti-CD20 mAbs has been shown to have an impact on these pathogenic mechanisms. 
The efficacy of three of them, rituximab, ocrelizumab and ofatumumab in MS has 
been confirmed by placebo-controlled clinical trials demonstrating a significant 
reduction of the annualized relapsing rate (ARR), new gadolinium-enhancing (GdE) 
and T2 lesions. There have been no significant safety problems so far but the 
overall benefit to risk profile is still to be determined. Expert commentary: 
After recent good results of these agents in MS therapy, questions related to 
maintenance therapy, markers of response and control of B cells values remain 
unanswered.