Published January 26, 2011 This content is archived.
In the first retrospective analysis of the response of children with multiple sclerosis to standard, first-line, therapies, researchers from the National Network of Pediatric MS Centers of Excellence found that one-fifth of patients in the review required “second-line” treatments.
The researchers also found that Hispanic children with MS were more likely to experience “breakthrough disease” while receiving first-line therapies than non-Hispanic children.
E. Ann Yeh, MD, assistant professor of neurology at UB, is first author of the study, Multiple Sclerosis Therapies in Pediatric Patients With Refractory Multiple Sclerosis, which was published online in the December 2010 issue of the Archives of Neurology.
In addition to UB, the National Network of Pediatric MS Centers includes Stony Brook University, University of California at San Francisco, University of Alabama-Birmingham, the Mayo Clinic, and Massachusetts General Hospital,
The review of data, which covered records of 243 children who were treated an average of 3.9 years, showed:
While most children switched to other first-line MS drugs, 55 children (21.3%) had to be switched to a variety of “second-line” drugs, such as broad-spectrum chemotherapies and corticosteroids, results showed. These children had shown MS relapses or new brain lesions detected on MRI scans.
“Multiple papers on the use of first-line therapies in the pediatric MS population have been published over the past 10 years, and the use of first-line therapies in this population has come to be accepted as relatively safe,” says Yeh. “In practice, however, we were seeing more and more children who continued to have very active disease despite use of first-line therapies.
“Little information on the use of second-line therapies in children with MS was available prior to the publication of this paper, so we set out to evaluate the use of second-line therapies in treatment-resistant cases of pediatric MS.”
MS commonly is considered a disease diagnosed in young to middle-aged adults. However, studies have determined that 8,000-10,000 children in the U.S. have MS, which accounts for two-to-five percent of those diagnosed with the disease. As many as 10,000-15,000 children are estimated to experience MS symptoms.
“The review clearly shows that a subset of children with pediatric MS has aggressive disease in need of chemotherapy or other second-line therapies and, further, that these second-line therapies may be well tolerated in this group,” says Yeh. It also suggests that almost 80 percent of children with MS will probably respond to one of the current FDA-approved first-line MS therapies, such as interferon and glatiramer acetate.
Additional authors on the paper, all from the National Network of Pediatric MS Centers of Excellence, are Emmanuelle Waubant, MD, PhD; Lauren B. Krupp, MD; Jayne Ness, MD, PhD; Tanuja Chitnis, MD; Nancy Kuntz, MD; Murali Ramanathan, PhD; Anita Bellman, MD; Dorothee Chablas, MD, PhD; Mark P. Gorman, MD; Moses Rodriguez, MD; John Robert Rinker II, MD; and Bianca Weinstock-Guttman, MD.
The research was supported by the National Multiple Sclerosis Society.