Winter Pia, Axhausen Franziska, Wolff Stephanie, Willison Alice Grizzle, Räuber Saskia, Konen Franz Felix, Schreiber Stefanie, Schwenkenbecher Philipp, Hagler Ramona, Ruck Tobias, Huttner Hagen B, Kleinschnitz Christoph, Pawlitzki Mark, Skripuletz Thomas, Pul Refik, Meuth Sven G, Pfeuffer Steffen
Department of Neurology, Justus-Liebig-University Giessen, Giessen, Germany.
Department of Neurology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
J Neurol Neurosurg Psychiatry. 2025 Jul 16;96(8):802-806. doi: 10.1136/jnnp-2024-335673.
The impact of body weight on disability progression rates among patients receiving ofatumumab was not evaluated yet.
Among patients from a multicentre prospective cohort, baseline demographics were compared among body mass index (BMI) quartiles as well as proportions of clinical relapses, MRI lesions and disability worsening during follow-up.
536 patients from four centres were included. Baseline demographics were evenly distributed among patients. Proportions of relapses and new/enlarging MRI lesions were comparable among BMI strata.Confirmed disability worsening was significantly more abundant among patients from the 4th BMI quartile (BMI ≥29.2 kg/m; adjusted HR: 3.33 (95% CI: 1.72 to 6.42; p<0.001). Relapse-associated worsening was not substantially different among relapsing patients from different BMI strata (HR: 1.19 (95% CI: 0.40 to 3.52; p=0.750)). Yet, progression independent from relapse activity was more likely in patients from 4th BMI quartile (HR: 2.00 (95% CI: 1.47 to 2.70; p<0.001)).Body weight (4th body weight quartile: ≥84.5 kg) was not associated with disability worsening (adjusted HR: 1.91 (95% CI: 0.97 to 3.76; p=0.060). Ofatumumab serum levels were lower in patients with higher BMI as well.
Inflammatory disease outcomes did not differ but disability progression was more frequent in the highest BMI quartile (BMI >29.2 kg/m). This was associated with lower ofatumumab serum levels. Since body weight itself was not predictive, we assume that body fat composition is critical for ofatumumab effectiveness.
尚未评估体重对接受奥法木单抗治疗的患者残疾进展率的影响。
在一个多中心前瞻性队列的患者中，比较了体重指数（BMI）四分位数之间的基线人口统计学特征以及随访期间临床复发、MRI病变和残疾恶化的比例。
纳入了来自四个中心的536名患者。基线人口统计学特征在患者中均匀分布。BMI各层之间的复发率和新出现/扩大的MRI病变比例相当。在BMI第四四分位数（BMI≥29.2kg/m²）的患者中，确诊的残疾恶化明显更为常见（校正风险比：3.33（95%置信区间：1.72至6.42；p<0.001））。不同BMI层的复发患者中，与复发相关的恶化没有实质性差异（风险比：1.19（95%置信区间：0.40至3.52；p=0.750））。然而，BMI第四四分位数的患者更有可能出现与复发活动无关的进展（风险比：2.00（95%置信区间：1.47至2.70；p<0.001））。体重（第四体重四分位数：≥84.5kg）与残疾恶化无关（校正风险比：1.91（95%置信区间：0.97至3.76；p=0.060））。BMI较高的患者中奥法木单抗血清水平也较低。
炎症性疾病结局没有差异，但BMI最高四分位数（BMI>29.2kg/m²）的患者残疾进展更频繁。这与较低的奥法木单抗血清水平有关。由于体重本身并无预测性，我们推测体脂成分对奥法木单抗的疗效至关重要。
