When an MS Drug Lowers More Than B Cells

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Key Takeaway

Ofatumumab, a B‑cell depleting drug used for relapsing MS, not only lowers B cells but also unexpectedly reduces some T cells, so doctors may need to adjust dosing to avoid over‑suppressing the immune system.

What They Found

1) Ofatumumab (OFA) is given to reduce B cells, which help drive MS relapses; researchers expected it would cause fewer side effects because blood levels are much lower than similar drugs. 2) In 38 people with relapsing MS treated for at least 5 months, B cells dropped as expected, but T cells (a different immune cell type) also went down in many patients even though they usually don't have the target marker. 3) Some patients showed low overall lymphocyte counts (called lymphopenia), and 7 of 33 had levels low enough to be called Grade 2 lymphopenia, which can raise infection risk. 4) One group previously treated with the drug natalizumab (NTZ) had higher B cell counts compared with others, showing past treatments can change how OFA affects the immune system. 5) The authors suggest that long-term continuous use of B‑cell depleting therapy can have a bigger impact on the immune system than expected and that spacing doses differently might lower the chance of over‑treatment.

Who Should Care and Why

1) People with relapsing MS should care because this shows a common MS medicine can lower more parts of the immune system than intended, which could raise infection risk or affect vaccine responses. 2) Caregivers should watch for more infections, slow wound healing, or unusual tiredness in the person they support, and tell clinicians about these signs. 3) Neurologists and MS nurses can use this information to consider blood tests or change how often they give OFA to keep immunity safer — like turning down the volume if a stereo is too loud. 4) Patients who recently used other MS medicines (for example, natalizumab) may respond differently to OFA and should discuss past treatments when planning therapy. 5) Overall, this matters for daily life because it may change how often you see your clinic for blood checks, how careful you need to be about infections, and how your treatment schedule is planned.

Important Considerations

1) This study was small (38 people) and observational, so the results show a possible concern but don’t prove everyone will have the same effect. 2) Not all patients had the same past treatments, and that can change immune responses, so individual results may vary — your doctor needs to interpret these findings for your case. 3) The study suggests dose spacing might help, but it did not test different schedules directly, so any changes should only be made with a clinician’s advice.

Categories:

Treatment Updates Clinical Trials MS Diagnostics

Article Topics:

CD3 + CD20+ cellsT-cell lymphopeniafingolimodmultiple sclerosisofatumumab

Whether you’ve recently been diagnosed with Multiple Sclerosis (MS) or are seeking to broaden your understanding of this complex, neurodegenerative disease, navigating the latest research can feel overwhelming. Studies published in respected medical journals like Multiple sclerosis journal - experimental, translational and clinical often range from early-stage, exploratory work to advanced clinical trials. These evidence-based findings help shape new disease-modifying therapies, guide symptom management techniques, and deepen our knowledge of MS progression.

However, not all research is created equal. Some clinical research studies may have smaller sample sizes, evolving methodologies, or limitations that warrant careful interpretation. For a more comprehensive, accurate understanding, we recommend reviewing the original source material—accessible via the More Details section above—and consulting with healthcare professionals who specialize in MS care.

By presenting a wide range of MS-focused studies—spanning cutting-edge treatments, emerging therapies, and established best practices—we aim to empower patients, caregivers, and clinicians to stay informed and make well-informed decisions when managing Multiple Sclerosis.

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