Posted on Children's health, Multiple Sclerosis

Multiple sclerosis – Early high-efficacy treatment reduces disability in children

New research presented today at ECTRIMS 2024 reveals that initiating monoclonal antibody therapy during childhood, rather than delaying treatment until early adulthood, significantly reduces long-term disability in multiple sclerosis (MS) patients.1
New research reveals that initiating monoclonal antibody therapy during childhood, rather than delaying treatment until early adulthood, significantly reduces long-term disability in multiple sclerosis patients.

The study used data from the French MS Registry, Italian MS Register, and the global MSBase Registry to analyze the outcomes of 282 patients with pediatric-onset MS. These patients began experiencing symptoms before the age of 18. They were divided into two groups based on when they started monoclonal antibody treatment: between the ages of 12 and 17 or 20 and 22.

To ensure an accurate comparison of the groups, the researchers used inverse probability treatment weighting based on propensity scores. This method took into account the initial differences between the groups in factors such as gender, age at symptom onset, time from onset to clinically definite MS, and the number of relapses. This approach allowed for a clear evaluation of how the timing of starting high-efficacy therapy influences disability outcomes for individuals aged 23 and older.

In a study using the Expanded Disability Status Scale (EDSS) to measure and monitor disability progression in MS, it was found that patients who started treatment between the ages of 12 and 17 (39% of the study group) had an average increase of only 0.40 points on the EDSS. In comparison, those who began treatment later (61% of the study group) had a 0.95-point increase on the EDSS.rease on the EDSS.

Between the ages of 23 and 27, the increase in EDSS scores from baseline was 0.57 points lower in the early treatment group compared to the late treatment group. The benefits of early treatment persisted throughout the median follow-up period of 10.8 years. Dr. Sifat Sharmin, research fellow in the Clinical Outcomes Research (CORe) Unit at the University of Melbourne and leader of the study, states, “The substantially lower risk of progressing to higher disability levels in the early treatment group was particularly evident in the moderate disability range, where further progression was reduced by up to 97%.”

“This study emphasizes the critical importance of early intervention in pediatric-onset MS,” emphasizes Dr. Sharmin. “Our findings indicate that starting high-efficacy therapies like ocrelizumab, rituximab, or natalizumab during childhood can significantly improve long-term outcomes, preserving neurological function and reducing disability progression.”