Ofatumumab

How it works

It binds CD20 on B lymphocytes, leading to their depletion and a reduction in the B-cell-driven inflammation responsible for relapses and central nervous system lesions.

Prescribing in practice

• Screen for hepatitis B before starting, as B-cell depletion can cause viral reactivation, and avoid initiating in active infection.
• It is suitable for home self-administration after appropriate training, with the first dose often given under supervision for injection reactions.
• Update vaccinations beforehand, as live vaccines are not recommended during treatment, and monitor for infections.

Monitoring

Monitor for infections and injection-related reactions, with hepatitis B screening and immunoglobulin levels checked as indicated.

Counselling the patient

• Learn correct subcutaneous injection technique and rotate sites.
• Report any signs of infection between doses.
• Ensure required vaccinations are completed before starting therapy.

Evidence & guidelines

Ofatumumab reduced relapse rate compared with an active comparator in pivotal trials and is recommended by NICE for relapsing multiple sclerosis.