Dimethyl Fumarate for Pediatric-Onset Multiple Sclerosis: A Systematic Review

Area of Science:

• Neurology
• Pediatric Neurology
• Pharmacology

Background:

• Dimethyl fumarate (DMF) is an oral disease-modifying therapy (DMT) approved for adult multiple sclerosis (MS).
• Its use in pediatric-onset multiple sclerosis (POMS) is being explored, particularly for self-administered oral DMT preference.
• This review systematically assesses DMF's safety and efficacy in POMS.

Approach:

• A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searched PubMed, Scopus, and Web of Science databases for relevant studies up to May 15, 2024.
• Data extraction and screening performed by two independent authors.

Key Points:

• Six studies involving 316 patients with POMS were included.
• DMF demonstrated efficacy in reducing MS relapses and magnetic resonance imaging (MRI) activity.
• The most common adverse events were gastrointestinal discomfort and facial flushing.

Conclusions:

• DMF can be considered for POMS as both a first-line and switching therapy.
• Despite a trend towards high-efficacy DMTs, DMF remains a suitable option for select POMS cases.
• DMF offers an acceptable safety and efficacy profile for managing pediatric MS.