rituximab + temelimab

Rituximab + temelimab is an investigational combination therapy for multiple sclerosis (MS), specifically studied in patients with relapsing forms of MS whose disability progresses despite effective control of inflammation and relapses. Rituximab is a monoclonal antibody targeting CD20 on B cells, leading to their depletion through mechanisms such as complement-dependent cytotoxicity (CDC) and antibody-dependent cellular cytotoxicity (ADCC). Temelimab is an immunoglobulin G4 monoclonal antibody that targets the human endogenous retroviral envelope protein, implicated in neurodegeneration associated with MS. The combination aims to address both neuroinflammation (via rituximab) and neurodegeneration (via temelimab), offering a dual approach to disease management. In the ProTEct-MS phase 2 trial, this combination demonstrated excellent safety and tolerability, with evidence suggesting protection against loss of cortical thickness by more than 50% compared to rituximab alone[1][3][5][7].