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Two-photon Imaging of Cellular Dynamics in the Mouse Spinal Cord
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Current therapeutic options in pediatric multiple sclerosis.

E Ann Yeh1

  • 1Department of Neurology, Division of Child Neurology, Pediatric MS Center of the JNI, SUNY Buffalo, Women and Children's Hospital of Buffalo, 219 Bryant St., Buffalo, NY, 14222, USA, yehann1@gmail.com.

Current Treatment Options in Neurology
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PubMed
Summary
This summary is machine-generated.

Pediatric multiple sclerosis (MS) management involves disease-modifying therapies (DMTs) and symptom control. First-line injectable DMTs are recommended, with oral agents still under investigation for pediatric use.

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Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Clinical Therapeutics

Background:

  • Relapsing-remitting pediatric multiple sclerosis (MS) requires comprehensive management strategies.
  • Current therapies focus on preventing relapses, treating acute attacks, and managing symptoms.
  • Limited data exists for novel oral agents in the pediatric MS population.

Purpose of the Study:

  • To outline current therapeutic approaches for relapsing-remitting pediatric MS.
  • To discuss the selection and sequencing of disease-modifying therapies (DMTs).
  • To address the management of acute relapses and associated symptoms.

Main Methods:

  • Review of established and emerging treatment guidelines for pediatric MS.
  • Analysis of first-line, second-line, and potential future therapeutic options.
  • Consideration of adjunctive therapies for symptom management and rehabilitation.

Main Results:

  • First-line DMTs for pediatric MS include injectable interferon beta (1a IM, 1a SC, 1b SC) and glatiramer acetate.
  • Second-line options like natalizumab, cyclophosphamide, and mitoxantrone require careful consideration due to potential serious side effects.
  • Oral agents (fingolimod, cladribine) show promise in adults but lack pediatric data; acute relapses may be treated with pulse methylprednisolone.

Conclusions:

  • Therapeutic decisions in pediatric MS should prioritize safety and efficacy, starting with established injectable DMTs.
  • Close monitoring for adverse effects is crucial, especially with potent second-line therapies.
  • Multidisciplinary care, including neuropsychological and physical therapy, is essential for managing cognitive and physical symptoms.