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Utilization and Treatment Patterns of Disease-Modifying Therapy in Pediatric Patients with Multiple Sclerosis in the
Insights
Many pediatric multiple sclerosis (MS) patients don't receive disease-modifying therapy (DMT) within a year of diagnosis. Early treatment failure is common, highlighting the need for prompt intervention with approved options.
Area of Science:
- Pediatric Neurology
- Clinical Therapeutics
- Epidemiology
Background:
- Understanding disease-modifying therapy (DMT) use in pediatric multiple sclerosis (MS) is limited.
- Treatment patterns for pediatric MS patients require further investigation.
Purpose of the Study:
- To examine DMT utilization and treatment patterns in newly diagnosed pediatric MS patients.
- To assess the proportion of pediatric MS patients receiving DMT within the first year of diagnosis.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) with MS diagnosis claims (2010-2016).
- Evaluation of DMT initiation, types of DMTs used, and treatment discontinuation/switching within 1 year post-diagnosis.
Main Results:
- Of 288 pediatric MS patients, 65.3% received no DMT within the first year.
- Injectable DMTs (interferons, glatiramer acetate) were most common first-line treatments (83%).
- Approximately 28% of patients discontinued or switched treatment within 6 months.
Conclusions:
- A significant number of pediatric MS patients remain untreated within one year of diagnosis.
- Early treatment failure affects about one-third of pediatric MS patients initiating therapy.
- Urgent consideration of approved treatment options for pediatric MS is warranted.
Background:
The current landscape and treatment patterns of disease-modifying therapy (DMT) use in pediatric patients with multiple sclerosis (MS) are not yet well understood. This study examined DMT utilization and treatment patterns in pediatric patients newly diagnosed as having MS.
Methods:
Pediatric patients (<18 years old) with two MS diagnosis claims from January 1, 2010, to December 31, 2016, were identified from the MarketScan Commercial Database. The index date was defined as the date of first MS diagnosis, and patients were followed up for 1 year post-index date. Outcomes evaluated included percentage of patients who initiated treatment after MS diagnosis, different DMTs initiated, treatment discontinuation, and switching treatment during follow-up.
Results:
Of 182,057 patients newly diagnosed as having MS, 288 pediatric patients (mean age, 14 years; 61% female) were identified. Within the first year of diagnosis, 188 patients (65.3%) did not receive any DMT. The most common first-initiated treatments were interferons and glatiramer acetate (83%), but 28% of patients switched or discontinued from first-initiated treatment within 6 months of treatment initiation.
Conclusions:
This study suggests that a considerable proportion of pediatric patients with MS remain untreated within 1 year of diagnosis. Patients most commonly initiated injectables as their first DMT. Overall, therapy failed early in approximately one in three patients. Thus, the study warrants urgency in treating these patients with currently approved treatment options.
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