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Treatment of multiple sclerosis in children and adolescents
Nancy L Kuntz1, Dorothee Chabas, Bianca Weinstock-Guttman
1Mayo College of Medicine, Mayo Pediatric MS Clinic, 200 1st Street SW, Rochester, MN 55905, USA. kuntz.nancy@mayo.edu
Insights
Pharmacotherapy for pediatric multiple sclerosis (MS) requires more research. Current treatments for children and adolescents need further study regarding effectiveness and long-term safety due to unique biological differences.
Area of Science:
- Neurology
- Pediatric Neurology
- Immunology
Background:
- Pediatric multiple sclerosis (MS) is an acquired inflammatory demyelinating CNS disorder.
- Accurate diagnosis is crucial with emerging disease-modifying therapies (DMTs).
- DMTs developed for adults are increasingly used in pediatric practice.
Purpose of the Study:
- To review pharmacologic treatments for pediatric MS.
- To discuss management strategies for acute CNS demyelination and DMTs.
- To explore symptomatic treatment options for improving quality of life.
Main Methods:
- Comprehensive literature review of pharmacologic treatments for MS.
- Emphasis on studies published over the last two decades.
- Inclusion of both adult and pediatric multiple sclerosis research.
Main Results:
- Review of research on treating acute CNS demyelination in children and adolescents.
- Discussion of strategies for introducing and modifying DMTs based on disease progression.
- Examination of medications for symptomatic relief and quality of life enhancement.
Conclusions:
- Pharmacotherapy for pediatric MS is less studied than in adults.
- Children and adolescents exhibit distinct drug metabolism, immune responses, and CNS myelin development.
- Further research is essential to establish effectiveness and long-term safety of MS treatments in pediatric populations.
Importance Of The Field:
Pediatric multiple sclerosis is an acquired inflammatory, demyelinating CNS disorder associated with recurrent episodes of neurologic dysfunction. Precise diagnosis is increasingly important as disease modifying therapies have been developed in adults and introduced into pediatric practice.
Areas Covered In This Review:
Literature published over the past two decades relating to pharmacologic treatment of multiple sclerosis (MS) in adults and children is reviewed, with emphasis on current publications.
What The Reader Will Gain:
This article reviews available research and clinical experience regarding treatment of acute episodes of CNS demyelination in children and adolescents, strategies for introduction and modification of disease-modifying therapies depending on disease course, and use of medication for symptomatic improvement in quality of life.
Take Home Message:
Pharmacotherapy for MS has been studied in adults but to a significantly lesser extent in children or adolescents. However, children and adolescents have different biology than adults in terms of drug metabolism, immune mechanisms and incomplete maturity of CNS myelin. Effectiveness as well as long-term safety needs to be studied in children and adolescents.
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