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Therapeutic Advances in Pediatric Multiple Sclerosis.
Rachel Walsh1,2, Tanuja Chitnis1,2
1Division of Child Neurology, Mass General Brigham Pediatric MS Center, Boston, MA 02114, USA.
Children (Basel, Switzerland)
|March 28, 2025
Summary
Pediatric-onset multiple sclerosis (POMS) treatments are evolving, with new therapies showing promise for children and adolescents. This review covers key clinical trials and treatment strategies for managing this chronic neurological condition.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Pediatric-onset multiple sclerosis (POMS) is a chronic, immune-mediated central nervous system disorder affecting 3-10% of MS patients before age 18.
- Most pediatric MS cases present with a relapsing-remitting course and significant disease activity.
- Historically, pediatric MS treatments were off-label, with limited success.
Purpose of the Study:
- To review therapeutic advancements in pediatric multiple sclerosis.
- To discuss the safety and efficacy of emerging treatments and monoclonal antibodies.
- To examine treatment strategies and considerations for POMS patients.
Main Methods:
- Narrative review of seminal clinical trials in pediatric MS.
- Evaluation of therapies including fingolimod, dimethyl fumarate, teriflunomide, ocrelizumab, and alemtuzumab.
- Review of safety and efficacy data for monoclonal antibodies.
Main Results:
- Seminal trials like PARADIGMS, CONNECT, TERIKIDS, OPERETTA I, and LEMKIDS have provided data on specific treatments for POMS.
- Emerging therapies and monoclonal antibodies offer new options for pediatric MS management.
- Evidence supports the evaluation of different treatment strategies, including induction versus escalation.
Conclusions:
- Therapeutic options for POMS have rapidly expanded with new drug approvals and clinical trial data.
- Understanding the safety, efficacy, and strategic application of these treatments is crucial for optimizing patient care.
- Further research and clinical experience are needed to refine treatment protocols for pediatric multiple sclerosis.
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