Contributions
Abstract: EP1317
Type: ePoster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Introduction: Around 3-5 % of multiple sclerosis (MS) cases have their first attack during childhood. Some of these patients continue to suffer acute relapses and progression of disability despite initiating an appropriate treatment, hence, there is justified need to introduce new biological therapies in pediatric population. Rituximab [Mabthera (R), Roche, Basel, Switzerland] is a monoclonal antibody directed against the B cell marker CD20, and was found quite successful in treatment of MS in adults.
Patients and methods: We report four cases of pediatric patients with MS, who were treated with Rituximab. Clinical outcome as well as safety profile of treatment were assessed.
Findings: Median age at disease onset was 13.7 years. In all patients high number of the lesions was found in MRI. The treatment with Rituximab was initiated 3, 4, 8 or 36 months after disease onset (median age 14.8). In two cases Rituximab was the first line of the treatment due to rapid progression of disease in the clinical status and MRI images. In other case, despite application of intravenous immunoglobulin, another relapse occurred within one month and Rituximab was introduced. In the fourth case, both interferon beta-1b and glatiramer acetate were tested sequentially, however, none of them stopped progression of disease and consecutive attacks. Finally, Rituximab was administrated 3 years after MS onset. In three patients no progression of MS was found in MRI images one or two years after administration of Rituximab (500 mg in a single dose). In one case progression of MS was observed in MRI after three months. Because of deep depletion of B-lymphocytes in all patients, further doses of Rituximab were not administrated.
In three patients a stabilization of clinical status was achieved despite the initial rapid progression.
Conclusions: This case series indicates that Rituximab may be a promising and effective complement to currently established treatment of MS in pediatric patients not responding to conservative therapy. Further research is required.
Disclosure: Nothing to disclose
Abstract: EP1317
Type: ePoster
Abstract Category: Clinical aspects of MS - 3 Paediatric MS
Introduction: Around 3-5 % of multiple sclerosis (MS) cases have their first attack during childhood. Some of these patients continue to suffer acute relapses and progression of disability despite initiating an appropriate treatment, hence, there is justified need to introduce new biological therapies in pediatric population. Rituximab [Mabthera (R), Roche, Basel, Switzerland] is a monoclonal antibody directed against the B cell marker CD20, and was found quite successful in treatment of MS in adults.
Patients and methods: We report four cases of pediatric patients with MS, who were treated with Rituximab. Clinical outcome as well as safety profile of treatment were assessed.
Findings: Median age at disease onset was 13.7 years. In all patients high number of the lesions was found in MRI. The treatment with Rituximab was initiated 3, 4, 8 or 36 months after disease onset (median age 14.8). In two cases Rituximab was the first line of the treatment due to rapid progression of disease in the clinical status and MRI images. In other case, despite application of intravenous immunoglobulin, another relapse occurred within one month and Rituximab was introduced. In the fourth case, both interferon beta-1b and glatiramer acetate were tested sequentially, however, none of them stopped progression of disease and consecutive attacks. Finally, Rituximab was administrated 3 years after MS onset. In three patients no progression of MS was found in MRI images one or two years after administration of Rituximab (500 mg in a single dose). In one case progression of MS was observed in MRI after three months. Because of deep depletion of B-lymphocytes in all patients, further doses of Rituximab were not administrated.
In three patients a stabilization of clinical status was achieved despite the initial rapid progression.
Conclusions: This case series indicates that Rituximab may be a promising and effective complement to currently established treatment of MS in pediatric patients not responding to conservative therapy. Further research is required.
Disclosure: Nothing to disclose