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Treatment of multiple sclerosis in children: A brief overview

Antonio Gennaro Nicotera1, Giulia Spoto1, Maria Concetta Saia1

  • 1Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, "Gaetano Barresi" University of Messina, 98125 Messina, Italy.

Clinical Immunology (Orlando, Fla.)
|February 5, 2022
PubMed

Insights

Pediatric-onset multiple sclerosis (MS) is rare but aggressive. Current treatments are adapted from adult studies, raising safety and efficacy concerns for children.

Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system.
  • Pediatric-onset MS (POMS) is a rare subtype characterized by a more aggressive disease course than adult-onset MS (AOMS).
  • Current POMS treatments are primarily extrapolated from adult data, lacking specific pediatric evidence.

Purpose of the Study:

  • To review common therapeutic strategies for POMS management.
  • To highlight concerns regarding the efficacy and safety of current POMS treatments in pediatric patients.
  • To share insights based on clinical practice and experience in managing POMS.

Main Methods:

  • Review of existing therapeutic approaches for POMS.
  • Analysis of clinical practice and individual experience in POMS management.
  • Discussion of extrapolated data from adult MS trials.

Main Results:

  • POMS exhibits higher relapse rates and greater neurological damage compared to AOMS.
  • Lack of pediatric-specific clinical trials necessitates reliance on adult data for treatment.
  • Existing therapeutic strategies raise questions about optimal efficacy and safety in children.

Conclusions:

  • There is a critical need for evidence-based therapeutic strategies tailored to POMS.
  • Further research and pediatric-specific trials are essential for optimizing POMS treatment.
  • Clinical experience suggests a cautious approach to extrapolated adult therapies in pediatric MS.
Keywords:
Demyelinating diseaseNatalizumabPediatric treatmentPediatric-onset multiple sclerosisRituximab

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