Newer disease modifying treatments in pediatric onset multiple sclerosis: Experience from a single center

Solmaz, Ismail; Acar-Ozen, Pinar; Parlak, Şafak; Tuncer, Aslı; Anlar, Banu

doi:10.1016/j.ejpn.2022.06.013

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…Only fingolimod and teriflunomide are approved in Europe for children. [33][34][35][36][37][38] Teriflunomide, fingolimod, dimethyl fumarate, rituximab, natalizumab, ocrelizumab, and alemtuzumab are used as primary/secondary or tertiary care in different positions in each country. Individualized treatment should also be considered in the POMS group.…”

Section: Treatments In Pediatric-onset Multiple Sclerosismentioning

confidence: 99%

Narrative review based on fingolimod therapy in pediatric MS

et al. 2023

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The course of pediatric-onset multiple sclerosis and adult multiple sclerosis shows some clinical differences. The rate of having a second attack after the first clinical event is 80% in children and around 45% in adults but the time to the second event is similar in all age groups. The pediatric group usually has a more aggressive onset than adults. On the other hand, a higher rate of complete recovery is observed in pediatric-onset multiple sclerosis after the first clinical event compared to the adult group. Despite a highly active initial disease course, pediatric-onset multiple sclerosis patients show a slower increase in disability than patients with adult-onset disease. This is thought to be due to greater remyelination capacity and plasticity of the developing brain. The management of pediatric-onset multiple sclerosis includes safety issues as well as effective disease control. In the pediatric-onset multiple sclerosis group, similar to adult multiple sclerosis, injectable treatments have been used for many years with reasonable efficacy and safety. Since 2011, oral treatments and then infusion treatments have been approved and used effectively in adult multiple sclerosis and have gradually entered clinical use in the pediatric-onset multiple sclerosis group. However, clinical trials are fewer, smaller, and include shorter follow-up due to the much lower prevalence of pediatric-onset multiple sclerosis than adult multiple sclerosis. This is particularly important in the era of recent disease-modifying treatments. This review of the literature presents existing data on the safety and efficacy of fingolimod, pointing to a relatively favorable profile.

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Section: Treatments In Pediatric-onset Multiple Sclerosismentioning

confidence: 99%

Narrative review based on fingolimod therapy in pediatric MS

et al. 2023

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Old and New Strategies in the Treatment of Pediatric Multiple Sclerosis: A Personal View for a New Treatment Approach

Ghezzi

2024

Neurol Ther

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Up to 10 years ago the most common approach to the treatment of pediatric MS (ped-MS) was to start with IFNB or GA (so-called first-line therapies or moderate-efficacy disease-modifying therapies [ME-DMTs]) and to switch to more aggressive treatments (or high-efficacy disease-modifying therapies [HE-DMTs]) in non-responder patients. The use of HE-DMTs as first choice was recommended in selected cases with an active, aggressive form of MS. Indications for the treatment of ped-MS were essentially derived from data of observational studies. Recently, results of three randomized clinical trials have been published as well as data from many observational studies evaluating the effect of new and more active DMTs, with clear evidence that HE-DMTs are more effective than ME-DMTs. Therefore, the paradigm of treatment for patients with MS onset before 18 years of age should be changed, offering treatment with HE-DMTs as first option, because of their superior effectiveness to prevent relapses and disease progression. HE-DMTs present an overall reassuring safety profile and obtain better adherence to treatment.

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Ocrelizumab/teriflunomide

2022

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Newer disease modifying treatments in pediatric onset multiple sclerosis: Experience from a single center

Cited by 4 publications

References 29 publications

Narrative review based on fingolimod therapy in pediatric MS

Narrative review based on fingolimod therapy in pediatric MS

Old and New Strategies in the Treatment of Pediatric Multiple Sclerosis: A Personal View for a New Treatment Approach

Ocrelizumab/teriflunomide

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