Ofatumumab a safe, effective alternative in B cell–depletion therapy
Ofatumumab appears to be effective and well-tolerated in the treatment of patients with long-standing systemic lupus erythematosus (SLE), offering an alternative to the B cell–depleting agent rituximab, according to a study.
The single-centre study included 16 patients who received ofatumumab, with 50 percent having prior exposure to cyclophosphamide and rituximab (median cumulative dose, 4 g). However, two patients were unable to complete treatment due to significant infusion reactions to ofatumumab, and were therefore excluded from the analysis.
Of the 14 patients (median age 34 years; median duration of SLE, 9.2 years), 12 achieved B cell depletion with ofatumumab. Indications were lupus nephritis (LN) in 12 patients, extra-renal flare in one and remission maintenance in the remaining patient. Treatment was associated with improvements in serological markers of disease activity, including antinuclear antibody, antidouble stranded DNA antibody and complement levels.
In the subgroup of patients treated for LN, half showed response and achieved renal remission by 6 months. Of the six nonresponders, one was retreated with ofatumumab and subsequently achieved remission, while the remaining five had progressive disease that was unresponsive to augmented immunosuppression with cyclophosphamide.
During a median follow-up of 28 months, five grade III infections were documented. No malignancies or deaths occurred.
According to researchers, ofatumumab is a potential alternative in patients who are intolerant of rituximab, with the drug proving to be safe and effective at inducing B cell depletion, with subsequent clinical responses.