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Updated: Sep 12, 2025
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Access to therapy for children and adolescents with multiple sclerosis: global considerations in preventing disease
E Ann Yeh1, Helen Tremlett2, Rabporn Suntornlohanakul3
1Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada; Program in Neuroscience and Mental Health-SickKids, Toronto, ON, Canada; Research Institute, University of Toronto, Toronto, ON, Canada.
Insights
Children with paediatric-onset multiple sclerosis face significant barriers to accessing vital therapies. This review highlights regional disparities and proposes solutions for equitable treatment access in this vulnerable population.
Area of Science:
- Neurology
- Paediatrics
- Public Health
Background:
- Paediatric-onset multiple sclerosis (MS) affects a small but significant young population.
- It is linked to severe long-term motor and cognitive deficits, depression, and fatigue.
- Disease-modifying therapies show promise in managing paediatric MS, but access remains a challenge.
Purpose of the Study:
- To review the literature on therapy access for children and adolescents with paediatric-onset MS.
- To identify barriers hindering equitable access to treatment.
- To propose future directions for improving therapy access.
Main Methods:
- Comprehensive literature review of published studies.
- Analysis of regional variations in therapy availability.
- Examination of factors influencing access to care, diagnosis, and insurance.
Main Results:
- Significant regional variability exists in the availability of MS therapies for paediatric patients.
- Barriers include delayed diagnosis, differing regulatory approvals, insurance limitations, and varying government support.
- Unequal access to care impacts long-term outcomes for children with MS.
Conclusions:
- Addressing disparities in paediatric MS therapy access is crucial.
- Policy changes and improved support systems are needed to ensure equitable treatment.
- Future efforts must focus on overcoming identified barriers for all young MS patients.
Abstract:
Paediatric-onset multiple sclerosis comprises approximately 1·5% of prevalent multiple sclerosis cases and is associated with higher disease burden, early and progressive motor and cognitive disability in young adulthood, and high levels of depression and fatigue. Observational data and randomised controlled trials have shown marked effects of multiple sclerosis disease-modifying therapies on MRI activity and long-term outcomes, including disease progression, in the paediatric population. We present a comprehensive review of published literature focused on issues of access to therapy in children and adolescents with paediatric-onset multiple sclerosis. In this Review, we identify regional variability in availability of multiple sclerosis therapies and examine issues, such as differences in access to care and time to diagnosis, criteria for regulatory approval, availability of insurance, and government supports. Finally, we outline specific future directions that should be taken to address these barriers and ensure better and equal therapy access for all children and adolescents with multiple sclerosis.
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