Current international trends in the treatment of multiple sclerosis in children-Impact of the COVID-19 pandemic.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 02 07 2021
revised: 06 09 2021
accepted: 23 09 2021
pubmed: 9 10 2021
medline: 17 12 2021
entrez: 8 10 2021
Statut: ppublish

Résumé

Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice. We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases. The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic. The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.

Sections du résumé

BACKGROUND BACKGROUND
Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice.
METHODS METHODS
We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases.
RESULTS RESULTS
The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic.
CONCLUSIONS CONCLUSIONS
The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.

Identifiants

pubmed: 34624643
pii: S2211-0348(21)00544-7
doi: 10.1016/j.msard.2021.103277
pmc: PMC8474759
pii:
doi:

Substances chimiques

Fingolimod Hydrochloride G926EC510T

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103277

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

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Auteurs

Fredrik Sandesjö (F)

Neuropediatric Unit, Department of Women´s and Children´s Health, Karolinska Institutet, Sweden.

Evangeline Wassmer (E)

Birmingham Women and Children's Hospital, School of Life and Health Sciences, Aston University, Birmingham, United Kingdom.

Kumaran Deiva (K)

Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Bicêtre Hospital, Pediatric Neurology Departement, and National Referral Center for rare inflammatory brain and spinal diseases, Le Kremlin-Bicêtre, France.

Maria Pia Amato (MP)

Department NEUROFARBA, University of Florence, Italy, IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.

Tanuja Chitnis (T)

Department of Neurology, Division of Child Neurology, Massachusetts General Hospital, Boston, MA, USA.

Cheryl Hemingway (C)

Department of Paediatric Neurology, Great Ormond Street Hospital for Children NHS Trust, London, UK.

Lauren Krupp (L)

NYU MS Comprehensive Care Center, Grossman School of Medicine, New York University, New York City, NY, USA.

Daniela Pohl (D)

Division of Neurology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.

Kevin Rostasy (K)

Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Germany.

Emanuelle Waubant (E)

UCSF Regional Pediatric MS clinic, Department of Neurology, San Francisco, CA 94158, USA.

Brenda Banwell (B)

The Children's Hospital of Philadelphia, Division of Neurology, Philadelphia, PA, USA; University of Pennsylvania, Departments of Neurology and Pediatrics, Perelman School of Medicine, Philadelphia, PA, USA.

Ronny Wickström (R)

Neuropediatric Unit, Department of Women´s and Children´s Health, Karolinska Institutet, Sweden. Electronic address: ronny.wickstrom@ki.se.

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Classifications MeSH