Inhibition of CD40L with Frexalimab in Multiple Sclerosis

The CD40-CD40L pathway has been shown to be involved in the pathogenesis of multiple sclerosis. In this phase 2, double-blind, randomized trial, the effect of intravenous and subcutaneous anti-CD40L monoclonal antibody (Frexalimab) was evaluated in patients with multiple sclerosis compared with placebo. Frexalimab reduced the number of new gadolinium-weighted T1 lesions at 12 weeks compared with placebo. In addition, NfL and CXCl13 levels at week 12 appeared reduced compared with placebo. The most frequent adverse reactions related to Frexalimab were headache and infections (especially Covid19 infection).