Using Ofatumumab for SLE When Rituximab Just Won’t Do

Rituximab is often associated with B cell depletion and is an evolving therapy for systemic lupus erythematosus (SLE). However, adverse events (AEs) with using rituximab are common and can be a deterrent in using the drug as a re-treatment in patients who previously demonstrated beneficial response. A study in Rheumatology looked at using ofatumumab as an alternative B cell–depleting agent in patients with SLE who could no longer continue to use rituximab because of AEs. 

Great paper by ⁦@kidneydoc101⁩ et al. I’ve also seen good results from Ofatumumab in those allergic to Rituximab. More evidence to hopefully support increased use in #sle https://t.co/vz63A4eLoM

— Chris Wincup (@chriswincup) June 25, 2018

Interesting alternative to Rituximab https://t.co/EfqiFE0HYM

— Tiberius Gracchus 🇵🇸 🍉 (@izharnephrol) June 25, 2018

The study was a single-center, retrospective case series. Sixteen patients were treated with ofatumumab for SLE between 2012 and 2015. The median age was 34 (range 19–55) and the median duration of SLE 9.2 years (0.6–28.5) According to the results, ofatumumab was well tolerated in 14 out of the 16 patients. Twelve patients were treated for lupus nephritis (LN), one for extra-renal flare and one for remission maintenance. In addition, B cell–depletion was achieved in 12 out of 14 patients. 

https://t.co/e70nOH2XaM #lupus #Bcelldepletion Originally approved for CLL and has distinct binding epitope from RTX

— Rajkiran Dudam (@RajkiranDudam) May 17, 2018

Half of the patients with LN achieved renal remission by 6 months. During long-term follow-up (median 28 months), five grade III infections were reported, but there were no malignancies or deaths. Researchers concluded that in patients with long-standing SLE and an allergy to rituximab, ofatumumab is a well-tolerated and effective alternative therapy for B cell–depletion therapy. 

SOURCE: Rheumatology