Publication date: Dec 11, 2025
Autoimmune encephalitis (AE), a prevalent neuroimmunological disorder, is primarily managed with immunotherapy. However, a subset of patients exhibits suboptimal responses to first-line treatments, and second-line options remain limited. This study investigates the efficacy and safety of a personalized ofatumumab (OFA) regimen guided by monitoring CD27 + CD19+ memory B cells in refractory AE. We report three cases of anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis and one case of antibody-negative AE (NA-AE) refractory to corticosteroids and intravenous immunoglobulin (IVIG). OFA was initiated at 20 mg subcutaneously on days 0 and 7, with subsequent doses administered when peripheral blood CD27 + CD19+ memory B cells exceeded 0. 05 % of peripheral blood mononuclear cells (PBMCs). After a median follow-up of 10 months (range: 6-12 months), all patients demonstrated clinical improvement, with significant reductions in modified Rankin Scale (mRS) and Clinical Assessment Scale in Autoimmune Encephalitis (CASE) scores. One patient experienced relapse post-SARS-CoV-2 infection, while the remainder remained recurrence-free without drug-related adverse events. CD27 + CD19+ memory B cell-guided OFA therapy may offer a novel strategy for refractory AE.
| Concepts | Keywords |
|---|---|
| 10months | Autoimmune encephalitis |
| Cd27 | Ofatumumab |
| Drugs | Personalized therapy |
| Immunotherapy | |
| Limited |
Semantics
| Type | Source | Name |
|---|---|---|
| drug | DRUGBANK | Ofatumumab |
| disease | MESH | autoimmune encephalitis |
| disease | MESH | encephalitis |
| drug | DRUGBANK | Immune Globulin Human |
| disease | MESH | mRS |
| disease | MESH | relapse |
| disease | MESH | SARS-CoV-2 infection |
| pathway | REACTOME | SARS-CoV-2 Infection |