Long-term outcome of paediatric-onset multiple sclerosis: a population-based study

Area of Science:

• Neurology
• Clinical Medicine
• Epidemiology

Background:

• Multiple sclerosis (MS) onset typically occurs in adulthood, with paediatric-onset MS (POMS) being rare.
• Limited longitudinal data exists for POMS, hindering optimal management strategies.
• Understanding POMS outcomes is crucial for improving patient care.

Purpose of the Study:

• To compare the clinical features and disease progression of POMS with adult-onset MS (AOMS).
• To identify distinct phenotypic characteristics of POMS.
• To inform management strategies for POMS.

Main Methods:

• A prospective, population-based register was used to identify patients with MS onset before 18 years.
• Clinical data, including time to disability milestones (Expanded Disability Status Scale 4.0, 6.0, 8.0) and secondary progression, were collected.
• POMS patient data were compared with those of AOMS patients.

Main Results:

• 111 POMS patients were identified (5.4% of the total MS cohort).
• POMS patients had a longer interval to the second relapse and less primary progressive disease compared to AOMS.
• POMS patients reached disability milestones and developed secondary progression at older ages but did so at younger chronological ages than AOMS patients.

Conclusions:

• Paediatric-onset MS (POMS) represents a distinct phenotype with unique early disease characteristics.
• Although POMS progression is slower, reaching disability milestones at a younger age indicates a potentially poorer long-term prognosis.
• Management of POMS should consider these distinct characteristics and prognosis.