Does Kesimpta (Ofatumumab) Cause Hyperglycemia?
No, there is no evidence in the medical literature that Kesimpta (ofatumumab) causes hyperglycemia. Based on available clinical data, hyperglycemia is not a reported side effect of ofatumumab therapy.
Evidence Review
Ofatumumab's Mechanism and Side Effect Profile
Ofatumumab is a fully human anti-CD20 monoclonal antibody used in the treatment of relapsing multiple sclerosis. Its mechanism involves:
- Selective targeting of B cells in the lymphatic system
- Binding to CD20 receptors on B cells with high affinity
- Causing rapid B-cell depletion through subcutaneous administration
According to the comprehensive research on ofatumumab's development and clinical use 1, the most common adverse effects include:
- Injection-related reactions (20% vs. 15% with placebo)
- Infections (51.6%, similar to comparison drug teriflunomide at 52.7%)
- Serious infections (2.5% vs. 1.8% with teriflunomide)
Notably, hyperglycemia is not mentioned among the documented adverse effects in this comprehensive review of ofatumumab's clinical profile.
Medications Known to Cause Hyperglycemia
Several medications are known to cause hyperglycemia, but ofatumumab is not among them. For example:
- Nilotinib has been documented to cause hyperglycemia in 6-12% of patients 2
- Protease inhibitors used in HIV treatment are associated with hyperglycemia and diabetes mellitus 2
- Teprotumumab (a different monoclonal antibody) has been associated with hyperglycemia in 5-12% of patients 3
- Enfortumab vedotin has been linked to severe hyperglycemia and even diabetic ketoacidosis 4, 5
Long-term Safety Data
The ALITHIOS extension study for ofatumumab has shown that long-term treatment (up to 4 years) is well-tolerated with no new safety risks identified 1. This further supports the absence of hyperglycemia as a significant concern with ofatumumab therapy.
Clinical Implications
Monitoring Recommendations
While hyperglycemia is not a reported concern with ofatumumab, general best practices for medication monitoring include:
- Baseline assessment of metabolic parameters before initiating therapy
- Routine follow-up laboratory testing as appropriate for the patient's underlying conditions
- Awareness of potential drug interactions that might affect glucose metabolism
Contrast with Known Hyperglycemia-Inducing Agents
Unlike medications such as nilotinib, which requires careful glucose monitoring due to its known effects on glucose metabolism 2, ofatumumab does not carry specific warnings regarding hyperglycemic effects.
Conclusion
Based on the available evidence, there is no indication that Kesimpta (ofatumumab) causes hyperglycemia. The medication's side effect profile has been well-characterized through clinical trials and post-marketing surveillance, and hyperglycemia has not emerged as a concern. Patients with diabetes or at risk for hyperglycemia can be reassured that ofatumumab therapy is not expected to adversely affect their glucose control.