Continuous ofatumumab treatment until the early third trimester in multiple sclerosis with preserved neonatal immunity

Evidence regarding neonatal immune outcomes following late-gestation exposure to ofatumumab remains limited. We report a 35-year-old woman with relapsing multiple sclerosis who continued ofatumumab until 28 weeks of gestation following individualized shared decision-making based on informed patient preference. The patient remained clinically and radiologically stable throughout pregnancy. Sustained maternal B-cell depletion enabled early postpartum resumption of maintenance therapy without re-induction. Although neonatal immune status at birth was unavailable, her infant showed normal B-cell counts during follow-up and completed routine vaccinations, including live vaccines, without complications. This case provides clinically relevant longitudinal neonatal immune and vaccination data following late-gestation ofatumumab exposure.