title: Natalizumab in pediatric multiple sclerosis: results of a cohort of 55 cases.
abstract: BACKGROUND
  Limited information is available on the use of natalizumab (NA) in pediatric multiple sclerosis (ped-MS) patients.
  
  
  OBJECTIVE
  The purpose of this study was to describe the long-term effects of NA in a large cohort of active ped-MS patients.
  
  
  METHODS
  Patients with definite ped-MS were treated with NA if in the previous year they had experienced at least two relapses or a severe relapse with incomplete recovery while on immunomodulating treatment, or at least two relapses and new magnetic resonance imaging (MRI) lesions regardless of any prior treatment.
  
  
  RESULTS
  The study included 55 patients (mean age: 14.4 years, mean number of relapses: 4.4, pre-treatment mean disease duration: 25.5 months). They received a median number of 26 infusions. Three relapses occurred during the follow-up, one female patient continued to deteriorate in cognitive functioning. Mean Expanded Disability Status Scale (EDSS) scores decreased from 2.7 to 1.9 at the last visit (p<0.001). During the follow-up the majority of patients remained free from MRI activity. Transient and mild clinical adverse events occurred in 20 patients. Mild hematological abnormalities occurred in seven patients. Anti-JCV antibodies were detected in 20/51 tested patients.
  
  
  CONCLUSIONS
  NA was well tolerated in all patients. A strong suppression of disease activity was observed in the majority of patients during the follow-up.
authors: Multiple Sclerosis Study Center, Hospital of Gallarate, Italy. angelo.ghezzi@aogallarate.it
authors: A
authors: A
authors: Ghezzi
authors: C
authors: C
authors: Pozzilli
authors: L M E
authors: LM
authors: Grimaldi
authors: L
authors: L
authors: Moiola
authors: V
authors: V
authors: Brescia-Morra
authors: A
authors: A
authors: Lugaresi
authors: G
authors: G
authors: Lus
authors: F
authors: F
authors: Rinaldi
authors: M A
authors: MA
authors: Rocca
authors: M
authors: M
authors: Trojano
authors: A
authors: A
authors: Bianchi
authors: G
authors: G
authors: Comi
authors: M
authors: M
authors: Filippi
mesh_terms: D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000473:pathology; D000069442:Natalizumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab
keywords: Multiple sclerosis; adolescence; childhood; natalizumab