Contributions
Abstract: 133
Type: Oral
Paediatric MS (i.e. onset of MS in patients that are younger than 18 years old) has the potential for irreversible CNS injury especially as it is still maturing. As such there is a need for early intervention to limit disability progression in paediatric MS. While several DMTs are approved for MS in adults, there are very few studies investigating their use in children. Interferons and glatiramer acetate have been the usual initial treatment choices for “typical” MS in children as open-label studies have shown they are safe, at least on the short term. Other drugs such as natalizumab, fingolimod, or rituximab (prescribed off-label) are possible options for highly-active MS, but very limited information is available from retrospective studies except for natalizumab. Several ongoing trials are investigating the use of fingolimod, teriflunomide, and dimethyl fumarate in paediatric MS, that will aid future treatment decisions including short-term safety information. Hopefully in the future prospective treatment registry in young patients will provide information on the long-term safety of DMT.
It is important to discuss treatment options with the patient, if they are old enough, and with the patient's parents and touch on the critical role of compliance in treatment effectiveness. Treatment compliance in teenagers can be a particular problem, with one study showing that up to a third of teenagers do not adhere to treatment. Discussing MS treatment options with teenagers, and understanding their expectations and preferences may help pick a treatment that will have a better patient adherence.
Disclosure: Emmanuelle Waubant: grants from NIH, NMSS, PCORI and Race to Erase MS
Abstract: 133
Type: Oral
Paediatric MS (i.e. onset of MS in patients that are younger than 18 years old) has the potential for irreversible CNS injury especially as it is still maturing. As such there is a need for early intervention to limit disability progression in paediatric MS. While several DMTs are approved for MS in adults, there are very few studies investigating their use in children. Interferons and glatiramer acetate have been the usual initial treatment choices for “typical” MS in children as open-label studies have shown they are safe, at least on the short term. Other drugs such as natalizumab, fingolimod, or rituximab (prescribed off-label) are possible options for highly-active MS, but very limited information is available from retrospective studies except for natalizumab. Several ongoing trials are investigating the use of fingolimod, teriflunomide, and dimethyl fumarate in paediatric MS, that will aid future treatment decisions including short-term safety information. Hopefully in the future prospective treatment registry in young patients will provide information on the long-term safety of DMT.
It is important to discuss treatment options with the patient, if they are old enough, and with the patient's parents and touch on the critical role of compliance in treatment effectiveness. Treatment compliance in teenagers can be a particular problem, with one study showing that up to a third of teenagers do not adhere to treatment. Discussing MS treatment options with teenagers, and understanding their expectations and preferences may help pick a treatment that will have a better patient adherence.
Disclosure: Emmanuelle Waubant: grants from NIH, NMSS, PCORI and Race to Erase MS