Extended dosing of monoclonal antibodies in multiple sclerosis

Zoé LE van Kempen*, Alyssa A Toorop, Finn Sellebjerg, Gavin Giovannoni, Joep Killestein

*Corresponding author for this work
5 Citations (Scopus)


Over the past two decades, treatment options for patients with multiple sclerosis (MS) have increased exponentially. In the current therapeutic landscape, "no evidence of MS disease activity" is within reach in many of our patients. Minimizing risks of complications, improving treatment convenience, and decreasing health care costs are goals that are yet to be reached. One way to optimize MS therapy is to implement personalized or extended interval dosing. Monoclonal antibodies are suitable candidates for personalized dosing (by therapeutic drug monitoring) or extended interval dosing. An increasing number of studies are performed and underway reporting on altered dosing intervals of anti-α4β1-integrin treatment (natalizumab) and anti-CD20 treatment (ocrelizumab, rituximab, and ofatumumab) in MS. In this review, current available evidence regarding personalized and extended interval dosing of monoclonal antibodies in MS is discussed with recommendations for future research and clinical practice.

Original languageEnglish
JournalMultiple Sclerosis Journal
Issue number13
Pages (from-to)2001-2009
Number of pages9
Publication statusPublished - Nov 2022


  • extended dosing
  • monoclonal antibodies
  • Multiple sclerosis
  • personalized dosing
  • Antineoplastic Agents, Immunological
  • Humans
  • Antibodies, Monoclonal/therapeutic use
  • Integrins/therapeutic use
  • Rituximab/therapeutic use
  • Natalizumab/therapeutic use
  • Multiple Sclerosis/drug therapy


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