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The ASCLEPIOS I and II phase 3 trials compared the B-cell-depleting monoclonal antibody ofatumumab with oral teriflunomide in patients with relapsing multiple sclerosis. Across the two studies, ofatumumab significantly reduced the annualised relapse rate and MRI evidence of new inflammatory disease compared with teriflunomide. The treatment effect was consistent across a broad relapsing-MS population and was accompanied by a manageable safety profile. The biological rationale is that selective depletion of CD20-positive B cells reduces immune activity implicated in multiple sclerosis. For HCPs, the clinical importance is that highly effective disease-modifying therapy can be delivered subcutaneously at home rather than through an infusion centre. The decision to use ofatumumab still requires attention to infection risk, vaccination status, immunoglobulin levels and patient preference. The trial also illustrates a wider change in MS treatment strategy: rather than escalating slowly through less effective agents in every patient, some patients may benefit from earlier use of a high-efficacy therapy. This is relevant to IANCON's emphasis on future-facing, disease-modifying neurology and precision treatment.
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The ASCLEPIOS I and II phase 3 trials compared the B-cell-depleting monoclonal antibody ofatumumab with oral teriflunomide in patients with relapsing multiple sclerosis. Across the two studies, ofatumumab significantly reduced the annualised relapse rate and MRI evidence of new inflammatory disease compared with teriflunomide. The treatment effect was consistent across a broad relapsing-MS population and was accompanied by a manageable safety profile. The biological rationale is that selective depletion of CD20-positive B cells reduces immune activity implicated in multiple sclerosis. For HCPs, the clinical importance is that highly effective disease-modifying therapy can be delivered subcutaneously at home rather than through an infusion centre. The decision to use ofatumumab still requires attention to infection risk, vaccination status, immunoglobulin levels and patient preference. The trial also illustrates a wider change in MS treatment strategy: rather than escalating slowly through less effective agents in every patient, some patients may benefit from earlier use of a high-efficacy therapy. This is relevant to IANCON's emphasis on future-facing, disease-modifying neurology and precision treatment.
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