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Ofatumumab: A Novel Anti-CD20 Monoclonal Antibody for Multiple Sclerosis: A Review of Clinical Considerations

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Abstract

Multiple sclerosis (MS), an autoimmune central nervous system disease responsible for significant morbidity and mortality worldwide, remains imperfectly understood and treated clinically. Recent advances in treating MS have come in the form of new immunomodulatory agents. Of these, anti-CD20 monoclonal antibodies (mAbs) have exhibited particular promise in treating relapsing–remitting multiple sclerosis (RRMS), the early stage of the disease where the adaptive immune system facilitates an autoimmune attack against myelin. The depletion of CD20 positive B cells in patients with RRMS has been associated with decreased symptoms, disease progression, and lesions on MRI, as well as a more favorable side effect profile relative to other immunomodulatory therapies for MS. Of the anti-CD20 mAbs available for use in MS, one of the newest is ofatumumab, a fully human anti-CD20 IgG1κ, sold under the trade name Kesimpta. The present investigation reviews the efficacy and safety of ofatumumab for MS, highlighting the role that B cells play in the initial inflammatory stage of MS and their depletion in decreasing clinical symptoms, T2-enhancing MRI lesions, and progression to the immune-independent phase of MS.

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Authors and Affiliations

  1. School of Medicine, Louisiana State University Health Sciences Center at New Orleans, 2020 Gravier Street, New Orleans, LA, 70112, USA

    William T. Barham, Kathryn M. Dillman, Joseph D. Hebert & Christian K. Kerut

  2. Department of Radiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Rachel J. Klapper

  3. Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Shahab Ahmadzadeh, Sahar Shekoohi, Elyse M. Cornett & Alan D. Kaye

  4. Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Alan D. Kaye

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Contributions

Conceptualization, William T. Barham, Kathryn M. Dillman, Joseph D. Hebert, Christian K. Kerut, Sahar Shekoohi, and Alan D. Kaye; methodology, William T. Barham, Kathryn M. Dillman, Joseph D. Hebert, Christian K. Kerut, Sahar Shekoohi, and Alan D. Kaye; writing—original draft preparation, William T. Barham, Kathryn M. Dillman, Joseph D. Hebert, and Christian K. Kerut; writing—review and editing, William T. Barham, Kathryn M. Dillman, Joseph D. Hebert, Christian K. Kerut, Rachel J. Klapper, Shahab Ahmadzadeh, Sahar Shekoohi, Elyse M. Cornett, and Alan D. Kaye; supervision, Shahab Ahmadzadeh, Sahar Shekoohi, Elyse M. Cornett, and Alan D. Kaye. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Sahar Shekoohi.

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Key points

•Recent advances in treating MS have come in the form of new immunomodulatory agents.

•Of the anti-CD20 mAbs available for use in MS, one of the newest is ofatumumab.

•The recommended dose schedule for ofatumumab is 20 mg subcutaneously, pre-filled automatically injecting syringe at weeks 0, 1, and 2.

•Randomized control trials of ofatumumab support its superiority to certain disease-modifying therapies (DMTs).

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Barham, W.T., Dillman, K.M., Hebert, J.D. et al. Ofatumumab: A Novel Anti-CD20 Monoclonal Antibody for Multiple Sclerosis: A Review of Clinical Considerations. SN Compr. Clin. Med. 6, 20 (2024). https://doi.org/10.1007/s42399-024-01649-7

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