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Ofatumumab for multiple sclerosis with disability accumulation.

Masahiro Mimori1, Atsuko Katsumoto2, Tomoko Okamoto2

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Ofatumumab may be less effective for multiple sclerosis (MS) patients with severe disability (high EDSS scores). Early treatment initiation in MS patients with lower EDSS scores may lead to better outcomes.

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Area of Science:

  • Neurology
  • Immunology

Background:

  • Ofatumumab has demonstrated efficacy in reducing relapse rates and disability progression in multiple sclerosis (MS).
  • However, its effectiveness in patients with severe disability, indicated by high Expanded Disability Status Scale (EDSS) scores, requires further investigation.

Purpose of the Study:

  • To evaluate the outcomes of ofatumumab treatment in MS patients with high EDSS scores and prolonged disease duration.
  • To identify factors associated with ofatumumab responsiveness in this patient population.

Main Methods:

  • Retrospective cohort study of MS patients treated with ofatumumab in Japan.
  • Patients were classified as treatment-responsive or treatment-resistant based on continuity, relapses with EDSS worsening, and progression independent of relapse activity (PIRA) at 12 months.
  • Logistic regression analysis was used to identify predictors of ofatumumab response.

Main Results:

  • Seventy patients (39 relapsing-remitting, 31 secondary progressive MS) with a median EDSS of 4.5 were analyzed.
  • Over half (56%) of the patients were classified as treatment-resistant, with higher resistance rates in secondary progressive MS (81%) compared to relapsing-remitting MS (33%).
  • Higher EDSS scores and achieving No Evidence of Disease Activity (NEDA-3) were independent factors associated with ofatumumab responsiveness.

Conclusions:

  • Ofatumumab treatment outcomes may be less favorable in MS patients with higher EDSS scores.
  • Initiating ofatumumab earlier, in patients with lower EDSS scores, might lead to more beneficial effects.