INTRODUCTION: Monoclonal antibodies play an important role in the therapy of 
different autoimmune diseases. With the introduction of natalizumab, the 
importance of monoclonal antibodies in the therapy of multiple sclerosis (MS) 
has dramatically increased during the past years.
AREAS COVERED: In this review, we will focus on newly approved and emerging 
antibodies for MS therapy. Based on published original articles and citable 
meeting abstracts, we will discuss their mode of action as well as data on 
efficacy and safety.
EXPERT OPINION: Natalizumab was a breakthrough in MS therapy. However, side 
effects of this monoclonal antibody limit its use. The risk/benefit ratios of 
new biologicals in MS therapy are not yet clear. High-yield process daclizumab 
might qualify as first-line MS therapy, unless hepatotoxicity becomes a relevant 
safety concern. Alemtuzumab has been approved for MS therapy in Europe but will 
be reserved for selected patients with highly active disease due to frequent 
induction of potentially dangerous secondary autoimmune phenomena. Ocrelizumab 
will likely also be licensed as a second-line therapy in highly active MS. 
Neutralizing antibodies to interleukin (IL)-17A and blocking antibodies to 
leucine rich repeat and Ig domain containing 1 might be the most interesting 
upcoming new antibodies as both offer a new and pathophysiologically relevant 
approach in MS therapy.