SPECIAL REPORT
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Patient satisfaction with high-efficacy therapies
Switching therapies
Real-world impact on PIRA
Over six thousand MS patients in Canada have been treated with ofatumumab, an anti-CD20 monoclonal antibody administered by self-injection, since it was authorized for use five years ago. A Canadian study has now examined patient acceptance of treatment in an analysis of patient support program (PSP) data (Selchen et al. Mult Scler Relat Disord 2026:107:106976). A total of 5436 of 6377 patients in the database met inclusion criteria. Treatment persistence was 96.94% at 12 months, 95.02% at 24 months and 92.26% at 36 months. The most common reasons for treatment discontinuation were side effects (0.9%), conception/pregnancy (0.5%) and patient request (0.5%).
Similarly, an analysis of PSP data in the U.K. found that the medication possession ratio (MPR), a measure of adherence, was >80% in 87.4% of patients at 13 months (Paling et al. Mult Scler Relat Disord 2026;107:107030). ARR decreased from 0.33 to 0.06. The most common adverse events were flu-like illness (10.3%) and headache (7.1%). No patients discontinued treatment during the 1-year period.
A Spanish real-world study examined ofatumumab use for the period 2022-2025 (Moreno-Navarro et al. Neurol Ther 2026;15:1703-1719). The rate of treatment persistence was 95.4% after a median of 22 months. The annualized relapse rate (ARR) declined from 0.48 at baseline to 0.03 with ofatumumab. Adverse effects included injection-related reactions (29.9%) and infections (6.9%). Immunoglobulin levels were mostly stable throughout the treatment period.
Patient satisfaction with high-efficacy therapies
Two recent studies compared treatment satisfaction with ofatumumab versus other high-efficacy therapies. An Italian study used a structured questionnaire to investigate patient satisfaction across different domains of functioning (Pastore et al. Drugs Real World Outcomes 2026;13:241-252). Ofatumumab was the more favoured treatment with respect to time/organizational burden of therapy, perceived impact of therapy, treatment administration experience and decision-making involvement compared to other DMTs such as natalizumab, ocrelizumab and alemtuzumab. The authors noted the importance of logistical and organizational factors when selecting the optimal therapy for individual patients.
A second propensity score-matched study examined a healthcare database to determine treatment adherence over 24 months during the period 2019-2023 (Tai et al. Mult Scler J Exp Transl Clin 2026;12:20552173261464369). Four groups were compared: ofatumumab, infusion DMTs, oral DMTs, and other injectable DMTs. At 18 months, adherence to ofatumumab was higher than to oral DMTs (73% vs. 51%) and to other injectables (74% vs. 40%); adherence to infusion DMTs was similar (74% vs. 70%). Adherence to ofatumumab remained higher than with oral DMTs (69% vs. 47%) and other injectables (70% vs. 35%) at 24 months. The 24-month adherence was 70% with ofatumumab compared to 65% with infusion DMTs.
Switching therapies
Ofatumumab is commonly used either as a first-choice agent or an early-switch therapy in the real-world setting. The utility of these approaches was examined in a retrospective Italian study (n=424) that compared ofatumumab in treatment-naïve patients as well as those switching from a moderate-efficacy or a high-efficacy therapy (Mangialardi et al. Drugs Real World Outcomes 2026;13:279-287). ARR decreased from 0.486 at baseline to 0.027 at a mean 1.32 years. Overall, 79.3% of patients achieved no evidence of disease activity (NEDA) at 12 months; ARR and NEDA rates were comparable across all subgroups. A noteworthy finding was that the risk of infection in patients initiated on ofatumumab was substantially lower compared to those switched from a high-efficacy therapy (0.9% vs. 9.5%). The authors concluded that ofatumumab is a generally effective option across various treatment sequences.
The effectiveness of an early switch to ofatumumab was supported by the results from the phase IIIb ARTIOS study (Bove et al. J Neurol 2026;273:434). A total of 562 patients with breakthrough disease activity while on fingolimod or a fumarate were switched to ofatumumab. Breakthrough disease activity was defined as >1 relapse in the prior year or >2 relapses in the prior two years and/or evidence of disease activity on MRI. ARR after the switch was 0.09 for those switching from fingolimod and 0.06 for those switching from fumarates. Overall, 90.9% achieved NEDA regardless of the prior DMT. The rate of six-month confirmed disability progression was 7.3%. Serious adverse events were uncommon (5.9%). Few patients discontinued treatment.
Real-world impact on PIRA
Two recent real-world studies examined the impact of ofatumumab on progression independent of relapse activity (PIRA). An Italian study examined the effectiveness of ofatumumab in 89 RMS patients (mean age 38 years) over a three-year period (Ziccardi et al. Ther Adv Neurol Disord 2026:19:17562864261434351). The overall rate of NEDA was 91%. Patients who failed to maintain NEDA were older and had greater disability at baseline. The rate of PIRA was low (7.9%) in this cohort. The rate of treatment discontinuation due to adverse effects was 2.2%.
An Australian MS clinic examined medical records for 170 patients (mean age 46.2 years) receiving ofatumumab for a mean of 18 months (Montague et al. Mult Scler J Exp Transl Clin 2026;12:20552173251414528). The NEDA rate was 96.5%. Twelve of 18 patients with PIRA in the year prior to treatment showed stabilization of PIRA after starting ofatumumab. The authors concluded that ofatumumab is highly effective in older patients with a longer disease duration.