Relapsing multiple sclerosis (RMS) management involves balancing the suppression of acute inflammation with the long-term preservation of neurocognitive function. Clinical data suggest that ofatumumab multiple sclerosis cognition impacts are promising for patients managed in real-world settings. A recent longitudinal study highlights how this high-efficacy anti-CD20 therapy influences both brain structure and patient performance over time.

Researchers observed 85 patients receiving ofatumumab, monitoring them through serial MRI scans and standardized cognitive testing. Initially, brain volume loss continued, but the rate of atrophy attenuated significantly after the first 12 months of treatment. Specifically, cortical thickness and deep gray matter volume showed slower rates of decline beyond the first year. These structural shifts align with the broader neuroprotective goals of modern disease-modifying therapies.

Real-World Gains in Ofatumumab Multiple Sclerosis Cognition

Regarding cognitive function, the Symbol Digit Modalities Test (SDMT) scores increased by an average of 3.79 points per year. Furthermore, patients demonstrated measurable gains in both verbal and visuospatial memory. Consequently, these improvements suggest that controlling active neuroinflammation may facilitate better neural compensation. Notably, the study found a positive correlation between the preservation of deep gray matter volume and the enhancement of cognitive processing speed.

Importantly, the findings emphasize that while some degree of brain atrophy persists, the slowing of neurodegeneration directly supports better clinical outcomes. Additionally, the increase in cognitive scores indicates that patients can experience functional recovery alongside inflammatory control. However, clinicians must continue to monitor long-term MRI trends to ensure sustained neuroprotection.

Frequently Asked Questions

How does ofatumumab multiple sclerosis cognition improvement manifest in patients?

Improvements primarily appear as increased processing speed and enhanced verbal or visuospatial memory. Patients often see significant gains in the Symbol Digit Modalities Test (SDMT) after long-term treatment.

Does ofatumumab stop brain atrophy entirely?

While brain atrophy often persists in the first year of treatment, research indicates that the rate of volume loss significantly attenuates after 12 months, particularly in the deep gray matter and cortex.

What is the link between brain structure and cognition in this study?

The study found that patients with higher baseline or better-preserved deep gray matter and thalamic volumes tended to show superior cognitive performance and faster processing speeds over time.

Disclaimer: This content is for informational and educational purposes only. It is not intended as medical advice or a substitute for professional clinical judgment. Always consult with a qualified healthcare provider for diagnosis and treatment. Refer to the latest local and national guidelines for clinical practice.

References

Zanghì A et al. Cognitive and structural brain changes in ofatumumab-treated multiple sclerosis: A longitudinal study. Neurotherapeutics. 2026 Jun 03. doi: undefined. PMID: 42235093.

Hauser SL et al. Six-year safety and efficacy outcomes with first-line ofatumumab in recently diagnosed treatment-naive patients with relapsing multiple sclerosis. Multiple Sclerosis and Related Disorders. 2026;105:106886.

Pardo G et al. Long-term safety and efficacy of ofatumumab in relapsing multiple sclerosis: 8-year analysis from the ALITHIOS open-label extension. Presented at the American Academy of Neurology (AAN) Annual Meeting, April 2026.