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

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.