Highlights
- •Of 214 patients diagnosed with MS before age 18, 140 started DMT prior to age 18.
- •The mean diagnostic delay decreased continuously during the years of observation.
- •The majority of children started treatment with a moderate-efficacy DMT.
- •During follow-up 108/140 (77%) children switched or discontinued DMT.
- •The use of DMT varied, depending on the availability of disease modifying drugs.
Abstract
Background
Several disease-modifying therapies (DMT) are being used in paediatric patients with
multiple sclerosis (MS) despite the limited number of randomised controlled clinical
trials leading to approved indication in children.
Objectives
The aim of this study was to describe clinical characteristics of the Danish population
of paediatric onset MS, and the patterns of DMT utilisation in patients who started
treatment before the age of 18 years.
Methods
We conducted a nationwide population-based cohort study, including 347 children with
paediatric-onset MS (<18 years). Subjects were followed until their 25th birthday or end of follow-up.
Results
Median age at onset and diagnosis was 15.8 years and 17.2, respectively. The majority
of the children had monosymptomatic presentation. In total, 140 children received
DMT before the age of 18. Most started treatment with a moderate-efficacy drug (90%)
of which interferon-beta was the most used (80%). However, since oral treatments became
available, these have increasingly been used. During follow-up, 108 children switched
or discontinued DMT. Fingolimod was prescribed more frequently than natalizumab as
escalation therapy.
Conclusion
We present that use of DMT in POMS varies over the observed period concurrently with
the availability of disease modifying drugs with progressive use of oral and high-efficacy
therapies.
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Article info
Publication history
Published online: October 08, 2019
Accepted:
October 4,
2019
Received in revised form:
September 7,
2019
Received:
June 26,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
