Therapy of multiple sclerosis in children and adolescents.
BACKGROUND
Paediatric multiple sclerosis accounts for up to 10% of all MS cases. The initial course of the disease is relapsing-remitting in most children, with a relapse rate generally higher than that observed in adult patients. There is published experience on the use of first-line disease modifying therapies in children with MS. However, about 1/3 of paediatric MS cases do not respond to IFN-beta or glatiramer acetate and continue to develop relapses and disease progression. These patients could be proposed to a second-line treatment.


METHODS
A comprehensive review of the published literature related to pharmacologic treatment of MS in adults and paediatric patients was performed. The recent literature has been extracted for new evidence from controlled trials in adult patients, and open treatment studies and reported expert opinion in paediatric patients.


RESULTS
No disease modifying drug has been approved for the treatment of children and adolescents with MS, although the currently available first-line therapies for adults seem to be safe and well tolerated in this population. Further studies are required to assess the safety and efficacy of second-line treatments in children with MS.


CONCLUSIONS
The present article constitutes an update of the existing publications regarding treatment of acute events of CNS demyelination in children and adolescents as well as considerations for the use of immunomodulatory therapies.
Tenembaum
Silvia N
SN
Referral Center for Paediatric MS and Related Disorders, Department of Neurology, National Paediatric Hospital Dr. J.P. Garrahan, Combate de los Pozos 1881, Buenos Aires, Argentina. silviatenembaum@hotmail.com
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002648:Child; D002986:Clinical Trials as Topic; D000068717:Glatiramer Acetate; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D056747:Immunomodulation; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000628:therapy*; D010455:Peptides / Q000627:therapeutic use; D010951:Plasma Exchange
D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D007372:Interferons