Alemtuzumab following natalizumab in highly active paediatric-onset multiple sclerosis

Monica Margoni1,2, Francesca Rinaldi1, Silvia Miante1

  • 1Multiple Sclerosis Centre of the Veneto Region (CeSMuV), University Hospital of Padua, Italy.

Insights

This study found that natalizumab followed by alemtuzumab is a safe and effective treatment for pediatric multiple sclerosis, maintaining no evidence of disease activity. Few mild reactions occurred, with no severe adverse events reported.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Pediatric-onset multiple sclerosis (MS) requires effective and safe treatment options.
  • Disease-modifying therapies are crucial for managing pediatric MS progression.

Purpose of the Study:

  • To evaluate the safety and efficacy of a natalizumab-to-alemtuzumab treatment switch in pediatric MS patients.
  • To assess infusion-associated reactions, severe adverse events, and disease activity status.

Main Methods:

  • A cohort of five pediatric MS patients (ages 16-17) was followed for a median of 3.9 years.
  • Patients received natalizumab, then switched to alemtuzumab after a mean of 25.6 infusions.
  • Safety and disease activity (no evidence of disease activity 3) were monitored.

Main Results:

  • Few mild to moderate infusion-associated reactions were observed during alemtuzumab infusions.
  • No severe adverse events were detected throughout the study period.
  • All patients maintained their no evidence of disease activity 3 status during follow-up.

Conclusions:

  • The therapeutic course of natalizumab followed by alemtuzumab is well-tolerated in pediatric MS.
  • This treatment strategy effectively maintains disease control in young patients with multiple sclerosis.

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