Monoclonal antibody therapies and their use in neurologic diseases

Drug	Target	Mechanism of Action	Condition Used	Adverse Effects
Ipilimumab, tremelimumab	CTLA-4	Anti-CTLA-4 selectively blocking CTLA-4	Metastatic melanoma, several types of advanced malignancy	Immune-related AEs such as hypophysitis, colitis, uveitis, dermatitis, and arthritis
Aducanumab	Amyloid β aggregates, including soluble oligomers and insoluble fibrils	Decrease CNS amyloid burden	MCI and mild Alzheimer disease	ARIA
Adalimumab	TNF-α	Blocks TNF-α interaction with p55 and p75 cell surface TNF receptors	RA, PsA, AS, IBD, JIA, and HS	Neurologic AEs including demyelinating diseases, ON, CIDPN, MNM, and GB
NTZ	α4β1 Integrin	Blocks entry of T cells into the CNS	Multiple sclerosis (RRMS)	PML, PML-IRIS, NTZ rebound

Note:—ON indicates optic neuritis; CIDPN, chronic inflammatory demyelinating polyneuropathy; MNN, mononeuritis multiplex; GB, Guillain-Barré syndrome; RRMS, relapsing-remitting MS; AS, ankylosing spondylitis; MCI, mild cognitive impairment; RA, rheumatoid arthritis; PsA, psoriatic arthritis; IBD, inflammatory bowel diseases; JIA, juvenile idiopathic arthritis, HS, hidradenitis suppurativa.