Contributions
Abstract: EP1314
Type: ePoster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Introduction: Recurrent demyelinating diseases during childhood are still a challenge. Pediatric multiple sclerosis (pMS) and neuromyelitis optica (pNMO) show some degree of overlapping but pNMO seems to be a more disabling disease. Randomized controlled clinical trials in children haven't been published to date. However, disease modified drugs (DMD) for MS and immunosuppressive agents for NMO remain the mainstay of the current treatment, based on the practice in adult patients.
Objectives: To evaluate the clinical and epidemiological features in patients with pediatric MS and NMO and compare both groups, in a Brazilian cohort.
Methods: Retrospective review of patients' files followed at the Neuroimmunology Clinic - Universidade Federal de São Paulo, Brazil, from 2005 to 2016, fulfilling the 2010 McDonald criteria for MS and the 2006 criteria for NMO with onset before 18 years. Statistical analysis was performed using chi-square, Fisher's exact test or Wilcoxon sign test when appropriate. The Kaplan-Meier method was used for estimating the time to reach EDSS 6. Data are presented as median and mean ± standard deviation and significance was set at P ≤ 0.05.
Results: Sixty-eight patients fulfilled the inclusion criteria for MS and 11 for NMO. The female:male ratio was 2,8:1 and 2,6:1 for MS and NMO, respectively. The mean ARR was 0.82 (±0.8) for MS and 1,5 (±1.8) for NMO; the mean PI was 0.31 (±0.4) for MS and 2.2 (±4.2) for NMO. Analyzing the number of relapses after and before the treatment with DMD for MS and azathioprine for NMO, both groups presented significant reduction in relapse rate. When comparing the groups, patients with NMO had higher EDDS on last appointment and they reached EDSS 6 earlier than those with MS.
Discussion: Pediatric demyelinating diseases in Brazil are similar to the diseases described in other countries with higher prevalence. Data suggests that NMO is more severe than MS in adults and this study shows that the same happens with pediatric patients. DMD treatment was effective in reduce relapse rate in MS and standard immunosuppression with azathioprine was effective in NMO. Treatment was well tolerated in both groups.
Conclusion: NMO is a more severe disease than MS in children. The treatment with DMD or azathioprine was safe and effective in the population analyzed.
Disclosure:
Manuela de Oliveira Fragomeni: nothing to disclose;
Maria Fernanda Capucho Reis de Campos: nothing to disclose;
Denis Bernardi Bichuetti: nothing to disclose;
Enedina Maria Lobato de Oliveira: nothing to disclose.
Abstract: EP1314
Type: ePoster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Introduction: Recurrent demyelinating diseases during childhood are still a challenge. Pediatric multiple sclerosis (pMS) and neuromyelitis optica (pNMO) show some degree of overlapping but pNMO seems to be a more disabling disease. Randomized controlled clinical trials in children haven't been published to date. However, disease modified drugs (DMD) for MS and immunosuppressive agents for NMO remain the mainstay of the current treatment, based on the practice in adult patients.
Objectives: To evaluate the clinical and epidemiological features in patients with pediatric MS and NMO and compare both groups, in a Brazilian cohort.
Methods: Retrospective review of patients' files followed at the Neuroimmunology Clinic - Universidade Federal de São Paulo, Brazil, from 2005 to 2016, fulfilling the 2010 McDonald criteria for MS and the 2006 criteria for NMO with onset before 18 years. Statistical analysis was performed using chi-square, Fisher's exact test or Wilcoxon sign test when appropriate. The Kaplan-Meier method was used for estimating the time to reach EDSS 6. Data are presented as median and mean ± standard deviation and significance was set at P ≤ 0.05.
Results: Sixty-eight patients fulfilled the inclusion criteria for MS and 11 for NMO. The female:male ratio was 2,8:1 and 2,6:1 for MS and NMO, respectively. The mean ARR was 0.82 (±0.8) for MS and 1,5 (±1.8) for NMO; the mean PI was 0.31 (±0.4) for MS and 2.2 (±4.2) for NMO. Analyzing the number of relapses after and before the treatment with DMD for MS and azathioprine for NMO, both groups presented significant reduction in relapse rate. When comparing the groups, patients with NMO had higher EDDS on last appointment and they reached EDSS 6 earlier than those with MS.
Discussion: Pediatric demyelinating diseases in Brazil are similar to the diseases described in other countries with higher prevalence. Data suggests that NMO is more severe than MS in adults and this study shows that the same happens with pediatric patients. DMD treatment was effective in reduce relapse rate in MS and standard immunosuppression with azathioprine was effective in NMO. Treatment was well tolerated in both groups.
Conclusion: NMO is a more severe disease than MS in children. The treatment with DMD or azathioprine was safe and effective in the population analyzed.
Disclosure:
Manuela de Oliveira Fragomeni: nothing to disclose;
Maria Fernanda Capucho Reis de Campos: nothing to disclose;
Denis Bernardi Bichuetti: nothing to disclose;
Enedina Maria Lobato de Oliveira: nothing to disclose.