To evaluate the efficacy and safety of ofatumumab in patients with MOGAD, and compare it with rituximab.

Ofatumumab is a fully human anti-CD20 monoclonal antibody. Emerging evidence from case reports supports the therapeutic potential of ofatumumab in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Twenty-two patients received ofatumumab for a median duration of 19.5 months (range 6-41). Among them, 18 patients (81.82%) remained relapse-free during follow-up. ARR significantly decreased from 0.99 (0-2.25) pretreatment to 0 (0-1.71) during ofatumumab therapy (p=0.0001). Through propensity score matching, 18 patients in the ofatumumab group and 18 patients in the rituximab group were compared. Ofatumumab was observed to be associated with a significantly lower risk of a second attack (HR 0.238, 95% CI 0.066 to 0.859, p=0.015) comoared to rituximab, even in patients with refractory courses. Adverse events were reported in 12 patients (54.55%) treated with ofatumumab, most of which were mild and occurred after the initial dose.