Author Of 1 Presentation
P1074 - Comparison of Treatment Choices in a Single Center Pediatric Onset Multiple Sclerosis Registry (ID 1852)
Abstract
Background
Management of Pediatric Onset Multiple Sclerosis (POMS) may be challenging. Three treatments are approved in Turkey: interferon-β, glatiramer acetate, fingolimod, other agents still being on off-label use.
Objectives
We aimed to evaluate POMS patients under new generation therapies (NGT) (teriflunomide, dimethyl fumarate, fingolimod, rituximab, ocrelizumab, natalizumab, alemtuzumab). We compared disease status and MRI parameters between patients under first-line injectable therapies or NGT as first choice.
Methods
POMS patients currently under NGT, either switched from an old injectable treatment (interferon-β or glatiramer acetate, Group1) or been under NGT from the beginning (Group2), were evaluated retrospectively. Their disease history, EDSS scores, imaging data before and after the NGT were evaluated. Brain and/or cervical MRIs were analyzed according to lesion load, lesion location, atrophy, Gadolinium (Gd) enhancing lesions, optic neuritis, spinal lesions.
Results
There were 41 patients (34 females: 7 males), 27 (65.9%) in Group1 and 14 (34.1%) in Group2. Mean age of onset was 14 (SD=2) years. Patients in Group1 switched to NGT mainly because of ineffectiveness (88.9%) while Group2 tended to stay under the same drug except 2 patients under teriflunomide switching to another NGT because of side effects. The NGTs in Group1 were fingolimod (n=13), DMF (n=7), teriflunomide (n=4), natalizumab (n=3) and in Group2, teriflunomide (n=11), dimethyl fumarate (n=2), fingolimod (n=1). Annualized relapse rate was 0.292 in Group1, 0.244 in Group2 (p=0.931). The MRI parameters and the follow up MRIs were not significantly different between Group1 and Group2. The current median EDSS scores were similar in both groups (1.5 and 0.5 respectively; p=0.171).
Conclusions
Fingolimod was the most frequently used NGT in patients where first-line drugs were ineffective and teriflunomide was the frequent choice if treatment was started with an NGT. Only a few patients needed second-line treatments as a first-choice option in our POMS group. We did not observe any significant difference between clinical and MRI status among POMS patients under the first-line of newer drugs, although the latter was associated with a slightly lower EDSS score.