Contributions
Abstract: P1182
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background: Pediatric-onset MS (POMS) has a unique clinical profile compared to the more common adult-onset MS (AOMS), including increased focal inflammation early in the disease, rarity of primary progressive disease course, and slower long-term disability progression. Whether there are also differences in cerebrospinal fluid biomarkers between children and adults with MS is not known.
Aim: We aimed to investigate whether oligoclonal bands (OCBs) or other routinely-analyzed CSF biomarkers differ between POMS and AOMS early in their disease.
Materials and methods: We used prospectively-collected data from the Swedish MS registry, which collates information from all 64 neurology clinics in the country. To fulfill inclusion criteria persons must have had definite MS with a lumbar puncture (LP) performed within 5 years of MS onset. POMS was defined as MS onset and LP performed < 18 years of age; adult-onset MS (AOMS) was defined as ≥18 years for both. We explored CSF OCB status, IgG levels, and mononuclear cell count in both groups. Comparisons between groups were made using logistic regression for OCB status (binary), and log-transformed linear regression models for IgG levels, and mononuclear cell count.
Results: A total of 4967 patients were included, 117 (2.4%) of whom were POMS. There were no differences in sex ratio, but AOMS patients were more likely to have a primary progressive course (p< 0.001). 110 POMS patients (94.0%) were OCB-positive, compared to 4306 (88.8%) of AOMS (odds ratio: 2.44; 95%CI:1.10-6.94, p< 0.001). The IgG index was comparable between groups (p=0.22). The number of CSF mononuclear cells in CSF was higher among POMS than AOMS (β-coefficient: 1.33; 95%CI:1.07 - 1.66, p< 0.001).
Conclusions:POMS patients had significantly more signs of intrathecal inflammation than AOMS in more often carrying OCBs and showing higher numbers of mononuclear cells in their CSF
This study provides evidence of the pathophysiological processes that may contribute to the clinical differences between POMS and AOMS
Disclosure: VDK receives funding from Stockholm County Council and previously received fellowship from Biogen and Novartis. AM has received speaker honoraria from Biogen.
JH has received honoraria for serving on advisory boards for Biogen, Sanofi-Genzyme and Novartis and speaker's fees from Biogen, Novartis, Merck-Serono, Bayer-Schering, Teva and Sanofi-Genzyme. He has served as P.I. for projects, or received unrestricted research support from, BiogenIdec, Merck-Serono, TEVA, Sanofi-Genzyme and Bayer-Schering. This MS research was funded by the Swedish Research Council and the Swedish Brain foundation.
KAM receives research funding from the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the Canadian Institutes of Health Research.
Abstract: P1182
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background: Pediatric-onset MS (POMS) has a unique clinical profile compared to the more common adult-onset MS (AOMS), including increased focal inflammation early in the disease, rarity of primary progressive disease course, and slower long-term disability progression. Whether there are also differences in cerebrospinal fluid biomarkers between children and adults with MS is not known.
Aim: We aimed to investigate whether oligoclonal bands (OCBs) or other routinely-analyzed CSF biomarkers differ between POMS and AOMS early in their disease.
Materials and methods: We used prospectively-collected data from the Swedish MS registry, which collates information from all 64 neurology clinics in the country. To fulfill inclusion criteria persons must have had definite MS with a lumbar puncture (LP) performed within 5 years of MS onset. POMS was defined as MS onset and LP performed < 18 years of age; adult-onset MS (AOMS) was defined as ≥18 years for both. We explored CSF OCB status, IgG levels, and mononuclear cell count in both groups. Comparisons between groups were made using logistic regression for OCB status (binary), and log-transformed linear regression models for IgG levels, and mononuclear cell count.
Results: A total of 4967 patients were included, 117 (2.4%) of whom were POMS. There were no differences in sex ratio, but AOMS patients were more likely to have a primary progressive course (p< 0.001). 110 POMS patients (94.0%) were OCB-positive, compared to 4306 (88.8%) of AOMS (odds ratio: 2.44; 95%CI:1.10-6.94, p< 0.001). The IgG index was comparable between groups (p=0.22). The number of CSF mononuclear cells in CSF was higher among POMS than AOMS (β-coefficient: 1.33; 95%CI:1.07 - 1.66, p< 0.001).
Conclusions:POMS patients had significantly more signs of intrathecal inflammation than AOMS in more often carrying OCBs and showing higher numbers of mononuclear cells in their CSF
This study provides evidence of the pathophysiological processes that may contribute to the clinical differences between POMS and AOMS
Disclosure: VDK receives funding from Stockholm County Council and previously received fellowship from Biogen and Novartis. AM has received speaker honoraria from Biogen.
JH has received honoraria for serving on advisory boards for Biogen, Sanofi-Genzyme and Novartis and speaker's fees from Biogen, Novartis, Merck-Serono, Bayer-Schering, Teva and Sanofi-Genzyme. He has served as P.I. for projects, or received unrestricted research support from, BiogenIdec, Merck-Serono, TEVA, Sanofi-Genzyme and Bayer-Schering. This MS research was funded by the Swedish Research Council and the Swedish Brain foundation.
KAM receives research funding from the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the Canadian Institutes of Health Research.