Addressing Injection Hesitancy in Shared Decision-Making for Ofatumumab in MS

Shared decision-making has become a foundational element of contemporary multiple sclerosis (MS) care, particularly as the number of available disease-modifying therapies has expanded. With options that now span injectable, oral, and infusion-based agents administered at varying intervals, clinicians are increasingly able to align treatment strategies with both clinical needs and individual patient preferences. Understanding patients’ concerns, expectations, and daily realities is essential to selecting and sustaining high-efficacy therapy in relapsing MS.

In this episode, Mitzi Joi Williams, MD, the founder and chief executive officer of Joi Life Wellness Group Multiple Sclerosis Center, describes how she incorporates shared decision-making into discussions around initiating high-efficacy agents such as ofatumumab (Kesimpta; Novartis) and other anti-CD20 therapies. She notes that, in contrast to earlier eras when choices were limited to a few injectable regimens, today’s broader therapeutic landscape allows for a more tailored approach. Williams reports that she typically leads with high-efficacy options, taking time to review routes of administration and potential adverse effects while exploring each patient’s priorities and concerns.

Williams also focuses on addressing hesitancy related to injections and self-administration, which she identifies as a common barrier. By explaining the mechanics of modern self-injection pens, she aims to dispel images of large syringes and complex preparation that many patients associate with injections from media or older therapies. She further notes that increasing familiarity with GLP-1 and other injectable medications has made patients more comfortable with the concept of self-injection, though some concerns still influence preferences. These factors are systematically explored in her shared decision-making conversations to determine whether a self-administered option like ofatumumab is an appropriate fit.