2026 American Academy of Neurology Abstract Website

Objective:

To evaluate the efficacy and safety of ofatumumab in patients with MOGAD, and compare it with rituximab.

Background:

Ofatumumab is a fully human anti-CD20 monoclonal antibody. Emerging evidence from case reports supports the therapeutic potential of ofatumumab in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Design/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, as measured by annualized relapse rate (ARR) and time to 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. ARR significantly decreased from 0.99 (0-2.25) pretreatment to 0 (0-1.71) during ofatumumab therapy (p=0.0001). Through propensity score matching, 18 patients in the ofatumumab group and 18 patients in the rituximab group were compared. Ofatumumab was observed to be associated with a significantly lower risk of a second attack (HR 0.238, 95% CI 0.066 to 0.859, p=0.015) comoared to rituximab, even in patients with refractory courses. Adverse events were reported in 12 patients (54.55%) treated with ofatumumab, most of which were mild and occurred after the initial dose.

Conclusions:

Ofatumumab showed favorable efficacy in reducing relapses in patients with MOGAD compared to rituximab.