ArticleFrontiers in immunology2025
Successful sequential treatment with ofatumumab followed by efgartigimod for refractory autoimmune encephalitis with dual anti-NMDAR and anti-GFAP antibody positivity: first case report.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of acute-phase immunotherapy for adult autoimmune encephalitis: a systematic review and network meta-analysis.Frontiers in immunology · 2026Pooled it
- Ofatumumab Therapy and Long-Term Seizure Outcomes of Patients With Relapsing Anti-NMDA Receptor Encephalitis.Annals of clinical and translational neurology · 2026Article
- Clinical characteristics of autoimmune GFAP astrocytopathy with concomitant Epstein-Barr virus positivity: a case series of 12 patients and literature review.Journal of neurology · 2026Review
- Clinical features and outcomes of anti-NMDAR autoimmune-related central nervous system involvement in patients with teratoma: a retrospective cohort study.BMC neurology · 2026Article
- Preliminary observations on the efficacy of efgartigimod in anti-LGI1-associated autoimmune encephalitis.Therapeutic advances in neurological disorders · 2026Article
- Immune checkpoint inhibitor-related kelch-like protein 11-IgG cerebellitis successfully treated with efgartigimod as rescue therapy: a case report.Frontiers in immunology · 2026Article
- An atypical case of overlapped anti-NMDA-R and anti-GFAP encephalitis secondary to a teratoma of the fallopian tube: a case report.BMC neurology · 2025Article
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6 authors.
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Abstract
Autoimmune encephalitis (AE) is a heterogeneous disorder mediated by autoantibodies targeting neuronal or glial antigens, with anti-NMDAR encephalitis being the most common subtype, while cases with dual antibody positivity remain exceedingly rare. Standard treatment involves stepwise immunotherapy, but refractory cases often require advanced therapies. This study presents the first reported case of dual anti-NMDAR and anti-GFAP antibody-positive refractory AE in a 24-year-old female who failed first-line treatments (steroids, IVIG) and ovarian teratoma resection. During disease progression, innovative sequential therapy with ofatumumab (OFA), a novel anti-CD20 monoclonal antibody, followed by efgartigimod, an FcRn antagonist, was employed to mitigate profound B-cell depletion risks. The patient exhibited significant clinical improvement, with reduced Modified Rankin Scale (mRS) scores from 5 to 1. OFA induced rapid B-cell depletion, while efgartigimod effectively cleared pathogenic IgG, demonstrating synergistic efficacy. Comparative analysis with literature cases highlighted the superiority of this sequential approach in balancing efficacy and safety.
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