Defining Long-Term Treatment Success With Ofatumumab in Relapsing MS

Long-term treatment goals in relapsing multiple sclerosis (MS) increasingly focus on achieving durable disease stability that mirrors outcomes observed in clinical trials. Beyond simply reducing relapse frequency, clinicians now routinely monitor MRI activity and disability trajectories to assess whether patients are maintaining control of inflammatory disease activity and avoiding confirmed disability progression over time. Composite measures such as no evidence of disease activity (NEDA) have become useful clinical benchmarks to capture these multiple dimensions of treatment response.

In this episode, Mitzi Joi Williams, MD, the founder and chief executive officer of Joi Life Wellness Group Multiple Sclerosis Center, explains how she defines long-term treatment success for patients with relapsing MS receiving high-efficacy therapy, including ofatumumab. She notes that her clinical targets are aligned with research outcomes, emphasizing the absence of new relapses, lack of new or enlarging MRI lesions, particularly enhancing lesions, and stability of disability measures. Williams highlights the growing emphasis over the past several years on reducing confirmed disability progression and frames NEDA-3 and NEDA-4 as practical composite endpoints that reflect these broader goals.

Williams also reviews the available long-term data supporting ofatumumab (Kesimpta; Novartis), citing the ASCLEPIOS I and II pivotal trials (NCT02792218; NCT02792231) and their extension phases. She points to sustained reductions in annualized relapse rate, MRI activity, and confirmed disability progression in pooled analyses, while acknowledging that “long term” remains relative given the overall timeframe of modern MS therapeutics. Ongoing follow-up and continuous patient–clinician dialogue are central to her approach, with treatment reassessed at each visit to ensure that stability is maintained and that therapy is adjusted if NEDA-like targets are not being met.