Neurol. praxi. 2019;20(3):201-203 | DOI: 10.36290/neu.2019.050

New treatment options for pediatric patients with multiple sclerosis

doc. MUDr. Jarmila Szilasiová, PhD.

Neurologická klinika UPJŠ LF a UNLP, Košice

Multiple Sclerosis (MS) in children represents approximately 5 % of all MS patients. Although the etiopathogenesis of this autoimmune disease is not clearly elucidated, genetic and environmental risk factors for the development of SM in children (obesity, smoking, D vitamin deficiency) are known. The pediatric form of MS is mostly manifested as a relapsing-remitting form. Treatment of the disease includes, in addition to treating relapses, immunomodulatory and symptomatic treatment. For active forms, treatment with DMT (Disease- modifying therapy) is a treatment that affects the course of the disease. Over the past decade, there has been a significant increase in new drugs indicated in adults with MS and some of them have also been used in pediatric patients, but as off-label treatment. By 2018, it was possible to administer two DMT first-line drugs – interferon beta 1a and glatiramer acetate in children with MS. Nearly half of pediatric patients have suboptimal treatment response and require escalation to more effective therapy – the second line DMT. Large observational studies have shown that natalizumab is effective in children and its safety profile is comparable to that seen in adults. The efficacy and safety of other second line DMTs in pediatric patients was published only from small number of patients and retrospective analyzes. Studies with a large number of phase III in pediatric patients are undergoing teriflunomide and dimethylfumarate. In December 2018, EMA approved fingolimod in children's indication based on the results of the PARADIGM clinical study.

Keywords: pediatric multiple sclerosis, treatment, DMT, fingolimod

Received: June 23, 2019; Accepted: June 25, 2019; Published: June 12, 2019  Show citation