Multiple sclerosis therapies in pediatric patients with refractory multiple sclerosis

Area of Science:

• Pediatric Neurology
• Neuroimmunology
• Clinical Therapeutics

Background:

• Current disease-modifying therapies (DMTs) show limited efficacy in adult multiple sclerosis (MS).
• Understanding refractory MS in pediatric patients on first-line DMTs is crucial.

Purpose of the Study:

• To evaluate the incidence and management of refractory MS in pediatric patients using first-line DMTs.
• To analyze treatment adjustments in children with MS across US pediatric MS centers.

Main Methods:

• A multicenter, retrospective study reviewed 258 pediatric MS patients.
• Evaluated medication changes due to refractory disease in pediatric-onset MS.
• Disease stability was defined by the absence of medication changes for breakthrough disease.

Main Results:

• Interferon beta and glatiramer acetate were the most common first-line DMTs.
• Over half of patients (55.8%) remained on one therapy; many required sequential treatments.
• Hispanic children showed a higher likelihood of breakthrough disease on first-line DMTs.

Conclusions:

• Switching first-line DMTs can be effective for refractory pediatric MS.
• A portion of pediatric MS patients may necessitate second-line treatments for disease management.