Pediatric multiple sclerosis before the paradigms study: Nine years of experience in a portuguese tertiary center

Abstract

Background: Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system that may have a pediatric onset. This study aims to provide a characterization of a pediatric-onset MS (POMS) population followed at our center in the 9-year period prior to the PARADIGMS study, which resulted in the first formal approval of a drug to treat POMS. Material and Methods: We performed a retrospective, observational and unicentric study. We included data from the records of patients with an MS diagnosis confirmed before the age of 18, according to the McDonald 2010 diagnostic criteria, from 1st January 2010 onwards. Results: In a group of 32 patients, 30 (73.3% female) fulfilled the inclusion criteria, with a mean age at diagnosis of 15.5±2.2 years and median value of Expanded Disability Status Scale (EDSS) score at diagnosis of 1.5. All the cases had relapsing-remitting MS and in 43.3% optic nerve involvement was the first clinical manifestation. At diagnosis, magnetic resonance imaging showed gadolinium-enhancing lesions in 50% of the cases and the study of cerebrospinal fluid revealed oligoclonal bands in 85.7%. Interferon beta-1a was the most frequent first treatment option. In a mean follow-up of 4.1±2.5 years, the treatment was changed in 67.9% of cases. On the last visit, the median EDSS score was 1.5. Conclusion: Our results are in line with contemporaneous research. As well as contributing an important descriptive analysis of this population’s characteristics, it also provides a window of opportunity for further prospective analyses regarding potential treatment paradigm changes.