Anti-CD20 versus Dimethyl Fumarate as First-Line Treatment for Pediatric Multiple Sclerosis: A Retrospective Cohort...

Area of Science:

• Neurology
• Immunology
• Pediatrics

Background:

• Consensus on first-line treatment for pediatric-onset multiple sclerosis (POMS) is lacking.
• Dimethyl fumarate (DMF) and anti-CD20 therapies are emerging as favorable options for pediatric MS.

Purpose of the Study:

• To compare the effectiveness and safety of DMF versus anti-CD20 therapies as a first-line treatment for POMS.
• To evaluate treatment outcomes including relapse rates and disability progression.

Main Methods:

• Retrospective cohort study conducted from July 2012 to July 2022.
• Included 39 pediatric MS patients under 18, treated with either DMF or anti-CD20 agents, with at least 12 months follow-up.
• Analyzed annualized relapse rate (ARR) and Expanded Disability Status Score (EDSS), alongside adverse events.

Main Results:

• Both DMF and anti-CD20 groups showed a significant reduction in median ARR from baseline to follow-up (p < 0.0001).
• No significant changes in median EDSS were observed in either group.
• 17/23 patients on DMF and 12/16 on anti-CD20 were relapse-free after 12 months; no significant differences in efficacy outcomes were found between groups.

Conclusions:

• Both DMF and anti-CD20 therapies significantly reduce ARR and disease activity in POMS with acceptable safety.
• No significant differences in efficacy were observed between DMF and anti-CD20 therapies in this cohort.
• Further clinical trials are warranted to confirm these findings.