Pediatric-onset Multiple Sclerosis treatment: a multicentre observational study comparing natalizumab with fingolimod

Related Experiment Video

Updated: May 5, 2026

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
09:38

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination

Published on: September 12, 2016

12.2K

Antonio Carotenuto1, Cristina Di Monaco2, Laura Papetti3

  • 1Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy. carotenuto.antonio87@gmail.com.

Journal of Neurology
|August 23, 2024
PubMed

Insights

Both natalizumab and fingolimod effectively manage relapses in pediatric-onset multiple sclerosis (POMS). Natalizumab also demonstrated a decrease in disability, potentially linked to higher baseline inflammation in these POMS patients.

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Clinical Therapeutics

Background:

  • Pediatric-onset Multiple Sclerosis (POMS) exhibits greater inflammatory activity than adult-onset MS.
  • Treatment options for POMS are restricted, with limited approved therapies and off-label use of others.

Purpose of the Study:

  • To compare the efficacy of natalizumab versus fingolimod in managing POMS.
  • To evaluate treatment effects on clinical and MRI outcomes in POMS patients.

Main Methods:

  • An observational, longitudinal, multicenter study involving POMS patients treated with natalizumab (N-POMS) or fingolimod (F-POMS).
  • Data collection included Annual Relapse Rate (ARR), Expanded Disability Status Scale (EDSS), Symbol Digit Modality Test (SDMT), and MRI activity at baseline, 12-18 months, and last observation.

Main Results:

  • N-POMS patients presented with higher baseline ARR, EDSS, and lower SDMT compared to F-POMS.
  • Both treatments improved ARR between baseline and 12-18 months; EDSS and SDMT improved only in the N-POMS group.
  • Long-term follow-up (66.1 months) showed sustained ARR control in N-POMS patients.

Conclusions:

  • Both natalizumab and fingolimod demonstrate high and sustained efficacy in controlling relapses in POMS.
  • Natalizumab treatment is associated with a decrease in disability in POMS, possibly due to baseline inflammatory activity.
Abstract

Keywords:
Multiple Sclerosisdisease modifying treatmentfingolimodnatalizumabpediatric multiple sclerosisreal-world study

More Related Videos

Positron Emission Tomography Imaging for In Vivo Measuring of Myelin Content in the Lysolecithin Rat Model of Multiple Sclerosis08:40

Positron Emission Tomography Imaging for In Vivo Measuring of Myelin Content in the Lysolecithin Rat Model of Multiple Sclerosis

Published on: February 28, 2021

4.1K
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy07:20

Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy

Published on: August 9, 2024

1.1K

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
780
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
897
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
703
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
31