Contributions
Abstract: EP1711
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Introduction: Pediatric multiple sclerosis (MS) comprises 2-5% of all cases of MS. Although first-line disease-modifying therapy (DMT) including interferons appear to be well tolerated in perdiatric MS, but recent publications highlight an increasing number of cases resistant to those first-line treatments. There is an urgent need for second-line treatment strategies for pediatric MS, and this is the case of highly active forms.
We report the case of highly active pediatric ms treated with natalizumab as first-line treatment over a period of 36 months.
Observation: This is a male child who was diagnosed at the age of 14 with highly active MS and a treatment with NATALIZUMAB 300 mg per month was proposed to him as first intention.
At the initiation of treatment the child´s expanded disability status scale (EDSS) was 4, and John Cunningham virus (JCV) serology was negative.
At 6 months of treatment the child had an EDSS of 1 with a persistent MRI activity.
At 12 months, a relapse was reported with an EDSS of 3 and cerebral/medullar MRI revealed a new demyelinating lesions with no signs of activity.
At the 13th infusion, the child's EDSS was 1 and a JCV seroconversion was noted with a JCV index of 0,33. After two years treatment the EDSS was 0 and the JCV index was 0,4 without any MRI activity. The clinical course was performed without any incident and the child had an MRI control and analysis of the JCV index every 6 months up to two years of treatment.
Following a radiological suspicion of progressive multifocal leukoencephalopathy (PML) the treatment was suspended at its 27 th infusion and levels of JCV replication in cerebrospinal fluid (CSF) measured via quantitative real-time PCR returned with a negative result. Given the child´s good tolerance and its clinical efficacy, the treatment was continued.
Currently the child has received a 36th infusion with a JCV index < 0,9 and no particular incident have been reported up to date. A cerebral MRI control is performed every 3 months with a JCV index analysis every 6 months.
Conclusion: Our case report indicate that natalizumab may be safe and effective against highly active MS in pediatric patients. Furthermore, the number of published case studies on children with highly active MS treated with natalizumab also rises, whereas long-term risks as well as therapeutic potential of this therapy in pediatric population have been at the centre of attention.
Disclosure: Nothing
Abstract: EP1711
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Introduction: Pediatric multiple sclerosis (MS) comprises 2-5% of all cases of MS. Although first-line disease-modifying therapy (DMT) including interferons appear to be well tolerated in perdiatric MS, but recent publications highlight an increasing number of cases resistant to those first-line treatments. There is an urgent need for second-line treatment strategies for pediatric MS, and this is the case of highly active forms.
We report the case of highly active pediatric ms treated with natalizumab as first-line treatment over a period of 36 months.
Observation: This is a male child who was diagnosed at the age of 14 with highly active MS and a treatment with NATALIZUMAB 300 mg per month was proposed to him as first intention.
At the initiation of treatment the child´s expanded disability status scale (EDSS) was 4, and John Cunningham virus (JCV) serology was negative.
At 6 months of treatment the child had an EDSS of 1 with a persistent MRI activity.
At 12 months, a relapse was reported with an EDSS of 3 and cerebral/medullar MRI revealed a new demyelinating lesions with no signs of activity.
At the 13th infusion, the child's EDSS was 1 and a JCV seroconversion was noted with a JCV index of 0,33. After two years treatment the EDSS was 0 and the JCV index was 0,4 without any MRI activity. The clinical course was performed without any incident and the child had an MRI control and analysis of the JCV index every 6 months up to two years of treatment.
Following a radiological suspicion of progressive multifocal leukoencephalopathy (PML) the treatment was suspended at its 27 th infusion and levels of JCV replication in cerebrospinal fluid (CSF) measured via quantitative real-time PCR returned with a negative result. Given the child´s good tolerance and its clinical efficacy, the treatment was continued.
Currently the child has received a 36th infusion with a JCV index < 0,9 and no particular incident have been reported up to date. A cerebral MRI control is performed every 3 months with a JCV index analysis every 6 months.
Conclusion: Our case report indicate that natalizumab may be safe and effective against highly active MS in pediatric patients. Furthermore, the number of published case studies on children with highly active MS treated with natalizumab also rises, whereas long-term risks as well as therapeutic potential of this therapy in pediatric population have been at the centre of attention.
Disclosure: Nothing