Lymphocyte-targeted therapy

Mechanism of action

Route/Dose

Results

Status

AEDs

Alemtuzumab

Anti-CD52

IV 12 mg dose/y

75% ↓ SAD (12 mg dose), 74% ↓ RR

Phase III

ITP (3 pts), Graves disease (20%)

Rituximab

Anti-CD20

IV (1 gram dose, Q2w, × 2)

91% ↓ CEL in RRMS

Phase II

Infusion reaction, allergies

Cladribine

Purine nucleoside analog

Oral (3.5 and 5.25 mg/kg total dose)

58% ↓ RR, 43% disease free

Phase III

HZV, lymphopenia, HA, nasopharyngitis, lymphopenia

Daclizumab

Anti-CD25/anti-IL2

SQ 2 mg/kg (Q2w)

72% ↓ CEL in RRMS patients

Phase II

Skin rash, chest discomfort, headaches, lymphopenia

CTLA4Ig

Prevents T cell activation

IV (2, 10.0, 20.0, or 35.0 mg/kg)

No significant changes

Phase I

Lymphadenopathy, urinary tract infections, headaches, blurred vision, and upper respiratory tract infections

Immune sequestration

Fingolimod

Sphingosine-1- phosphate (S1P) analog

Oral (1.25 and 5 mg)

80% ↓ CEL, 50% ↓ RR

Phase III

Bradycardia, nasopharyngitis, dyspnea, headaches, diarrhea, nausea, encephalitis, skin cancer

SB-683699

Alpha-4 integrin antagonist

Oral (150 - 1200 mg Twice Daily)

No data available

Phase II

No data available

Unspecific immune suppression

Laquinimod

Antiinflammatory

Oral 0.6 mg/d

40% ↓ CEL

Phase III

LFT elevation, Budd Chiari

Fumaric acid (BG12)

Antiinflammatory/ Neuroprotective

Oral (120 - 240 mg TID)

69% ↓ CEL

Phase III

Diarrhea, cramps, nausea and flushing

Teriflunomide

Inhibition of immune cell proliferation

Oral (7 and 14 mg dose)

61% ↓ CEL

Phase II

Nasopharyngitis, alopecia, nausea, limb pain, diarrhea, and arthralgia