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Frexalimab is a second-generation investigational monoclonal antibody that targets and inhibits CD40 ligand (CD40L), thereby blocking the costimulatory CD40/CD40L pathway. This pathway is crucial for the activation and function of both adaptive (T and B cells) and innate (macrophages, microglia, dendritic cells) immunity. By inhibiting this interaction, frexalimab aims to reduce neuroinflammation in multiple sclerosis (MS) without causing lymphocyte depletion. It is being developed primarily for relapsing forms of MS as well as non-relapsing secondary progressive MS, with additional studies ongoing in immunology indications such as type 1 diabetes. Frexalimab has demonstrated significant reductions in new brain lesions and sustained disease control over two years in clinical trials[2][4][5][6].
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