Ofatumumab in Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease: A Comparison With Rituximab

OBJECTIVE: To evaluate the efficacy and safety of ofatumumab in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and compare it with rituximab. METHODS: We conducted a single-center, observational study including 22 MOGAD patients treated with ofatumumab and 21 treated with rituximab. The primary outcome is relapse, while the secondary outcomes are disability status and adverse events. RESULTS: Twenty-two patients received ofatumumab for a median duration of 19.5 months (range 6-41). Among them, 18 patients (81.82%) remained relapse-free during follow-up. Annualized relapse rate (ARR) significantly decreased from 1.30 (95% CI 0.74-2.29) pretreatment to 0.12 (95% CI 0.04-0.35) during ofatumumab therapy (IRR 10.86, 95% CI 3.22-36.70, p < 0.001). Through propensity score matching, 11 patients in the ofatumumab group and 11 patients in the rituximab group were compared. Ofatumumab was observed to be associated with a significantly lower risk of a second attack (HR 0.233, 95% CI 0.061 to 0.893, p = 0.018) compared to rituximab. Adverse events were reported in 54.55% patients (6/11) treated with ofatumumab, most of which were mild and occurred after the initial dose. INTERPRETATION: Ofatumumab was associated with a lower relapse risk compared with rituximab in patients with MOGAD.