Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Current and Emerging Treatment Options in Pediatric Onset Multiple Sclerosis

Artemis Mavridi
ORCID logo ,
Maria Eleni Bompou
,
Aine Margaret Redmond
,
Paraschos Archontakis-Barakakis
,
George D. Vavougios
ORCID logo ,
DIMOS-DIMITRIOS MITSIKOSTAS
,
Theodoros Mavridis
* ORCID logo
Version 1 : Received: 17 February 2024 / Approved: 18 February 2024 / Online: 19 February 2024 (14:52:05 CET)

A peer-reviewed article of this Preprint also exists.

Mavridi, A.; Bompou, M.E.; Redmond, A.; Archontakis-Barakakis, P.; Vavougios, G.D.; Mitsikostas, D.D.; Mavridis, T. Current and Emerging Treatment Options in Pediatric Onset Multiple Sclerosis. Sclerosis 2024, 2, 88-107. Mavridi, A.; Bompou, M.E.; Redmond, A.; Archontakis-Barakakis, P.; Vavougios, G.D.; Mitsikostas, D.D.; Mavridis, T. Current and Emerging Treatment Options in Pediatric Onset Multiple Sclerosis. Sclerosis 2024, 2, 88-107.

Abstract

Pediatric onset multiple sclerosis (POMS), characterized by the onset of multiple sclerosis before the age of 18, is gaining increased recognition. Approximately 5 percent of MS cases manifest before the age of 18, with less than 1 percent occurring before the age of 10. Despite its rarity, pediatric MS exhibits distinct characteristics, with an association between younger age at onset and a comparatively slower disease progression. Despite this slower progression, individuals with POMS historically reach disability milestones at earlier ages than those with adult-onset multiple sclerosis. While various immunomodulatory agents demonstrate significant benefits in MS treatment, such as reduced relapse rates and slower accumulation of brain lesions on magnetic resonance imaging (MRI), the majority of disease-modifying therapies (DMTs) commonly used in adult MS lack evaluation through pediatric clinical trials. Current evidence is predominantly derived from observational studies. This comprehensive review aims to consolidate existing knowledge on the mechanisms of action, efficacy, safety profiles, and recommended dosages of available DMTs specifically in the context of pediatric MS. Furthermore, the review outlines recent advancements and explores potential medications still in developmental stages, providing a thorough overview of the current landscape and future prospects for treating POMS.

Keywords

POMS; Pediatric Onset Multiple Sclerosis; Disease-modifying therapies; DMT; Pediatric MS; Interferons; Finglolimod; Teriflunomide; Cyclophosphamide; Rituximab; Ocrelizumab; Daclizumab; Alemtuzumab; Natalizumab; Ofatumumab; Siponimod; Vitamin D; TCR vaccine; Stem cell therapy; Glatiramer acetate; Azathioprine; Dimethyl fumarate; Mitoxantrone

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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