Neurológia pre prax 5/2023

Efficacy and safety of ofatumumab in naive MS patients.

“Early Intensive Treatment of Multiple Sclerosis (MS)” as a strategy for high-efficacy therapy with favorable side effect profile, comparable with first-line therapies, offers the opportunity to utilize a therapeutic window to prevent further damage to brain tissue. Significant progress has been made in the field of MS treatment during recent years. Our understanding of the immunopathophysiology of MS has dramatically improved. Traditional perspectives centered just around T cell-mediated immune responses have been gradually abandoned. Current knowledge supports the theory of mutual interactions among various types of immune cells, including B cells, both in the periphery and within the central nervous system. This has led to the introduction of anti-CD20 monoclonal antibodies into MS treatment, representing an innovative therapeutic approach for patients with relapsing-remitting and progressive forms of MS. An example of such treatment is ofatumumab. Ofatumumab is the fully human anti-CD20 monoclonal antibody administered at a monthly dosage of 20 mg subcutaneously. It was approved by the FDA in August 2020 and subsequently by the EMA in March 2021 for the treatment of adult patients with relapsing forms of MS. However, it has been shown that ofatumumab can be equally effective for treatment of naive patients. This review thus summarizes the current knowledge of SM etiopathogenesis as a basis of the efficacy and safety of ofatumumab in the subpopulation of treatment-naive patients.

Keywords: escalation treatment strategies, multiple sclerosis, disease modifying therapy, monoclonal antibodies, neurodegeneration