Review article

https://doi.org/10.24869/psyd.2023.8

MONOCLONAL ANTIBODY THERAPY IN AUTOANTIBODY-ASSOCIATED PSYCHOTIC DISORDERS AND SCHIZOPHRENIA: NARRATIVE REVIEW OF PAST AND CURRENT CLINICAL TRIALS

Niels Hansen ; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany ; Translational Psychoneuroscience, University Medical Center Göttingen, Germany
Berend Malchow ; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany

Abstract

Neural cell-surface autoantibody-associated psychiatric disease and a subgroup of psychotic disorders are probably caused by
an immune dysregulation such as B-cell related autoantibody production. In this review we describe past and current randomized
placebo-controlled trials investigating monoclonal antibodies as therapy for autoantibody-associated psychiatric disease and
psychotic disorders, aiming to delineate the current landscape of such monoclonal antibodies in autoantibody-associated psychiatric
disease and psychotic disorders, as well as perspectives for future trials. Rituximab and ocrelizumab are now being tested in clinical
trials, whereas the initial results on tocilizumab are controversial, as they demonstrated a cognitive-function benefit in an open label
study in schizophrenic patients – results that were not replicated in a randomized placebo-controlled trial. Adalinumab as TNFalpha
blockage was effective in treating positive and negative symptoms in schizophrenia. These findings demonstrate that
monoclonal antibody therapy is a potentially promising option to treat subgroups of schizophrenia and autoantibody-associated
psychiatric patients, but it should be investigated in more placebo-controlled, double-blind trials with large cohorts.

Keywords

autoantibody; psychiatric disease; psychotic disorder; schizophrenia; clinical trial

Hrčak ID:

307215

URI

https://hrcak.srce.hr/307215

Publication date:

17.4.2023.

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