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Elevated relapse rates in pediatric compared to adult MS persist for at least 6 years

L A Benson1, B C Healy2, M P Gorman3

  • 1Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, 1 Brookline Place, Boston, MA, USA; Department of Neurology, Boston Children's Hospital, Boston, MA, USA.

Multiple Sclerosis and Related Disorders
|April 17, 2015
PubMed

Insights

Pediatric-onset multiple sclerosis (POMS) patients experience higher relapse rates than adult-onset multiple sclerosis (AOMS) patients for the first six years. However, disability progression, measured by expanded disability status scale (EDSS), did not differ between groups.

Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Background:

  • Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • Pediatric-onset multiple sclerosis (POMS) represents a distinct subset with unique clinical characteristics.
  • Understanding early disease activity is crucial for effective management and treatment strategies.

Purpose of the Study:

  • To compare relapse rates in pediatric-onset multiple sclerosis (POMS) versus adult-onset multiple sclerosis (AOMS) over the initial six years of disease.
  • To investigate the relationship between relapse activity and disability progression in early POMS.

Main Methods:

  • Retrospective analysis of 84 POMS and 258 AOMS patients with relapsing-remitting disease.
  • Annualized relapse rates (ARR) and expanded disability status scale (EDSS) scores were compared yearly for six years post-onset.
  • Poisson regression was used to analyze relapse rates, adjusting for demographic factors.

Main Results:

  • POMS patients exhibited significantly higher ARR compared to AOMS patients in most of the first six years.
  • Despite a 2.30 times higher relapse rate over six years, EDSS scores did not differ significantly between POMS and AOMS groups.
  • Early relapse activity (years 1-5) did not predict year 5 disability in POMS patients.

Conclusions:

  • Higher relapse rates in POMS are sustained over six years, suggesting a more inflammatory disease course.
  • A potential disconnect exists between early relapse frequency and disability accumulation in POMS, as measured by EDSS.
  • These findings have implications for designing future clinical trials and therapeutic strategies for pediatric multiple sclerosis.
Abstract

Keywords:
AttackDemyelinationDisabilityMultiple sclerosisPediatricRelapse

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