Therapy of highly active pediatric multiple sclerosis
Objective: Study aims were to determine the frequency of highly active disease in pediatric multiple sclerosis (MS), the response to natalizumab (NTZ) and fingolimod (FTY) treatment, and the impact of current treatment modalities on the clinical course. Methods: Retrospective single-center study in...
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| Veröffentlicht in: | Multiple sclerosis 2019-01, Vol.25 (1), p.72-80 |
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| creator | Huppke, Peter Huppke, Brenda Ellenberger, David Rostasy, Kevin Hummel, Hannah Stark, Wiebke Brück, Wolfgang Gärtner, Jutta |
| description | Objective:
Study aims were to determine the frequency of highly active disease in pediatric multiple sclerosis (MS), the response to natalizumab (NTZ) and fingolimod (FTY) treatment, and the impact of current treatment modalities on the clinical course.
Methods:
Retrospective single-center study in the German Center for MS in Childhood and Adolescence.
Results:
Of 144 patients with first MS manifestation between 2011 and 2015, 41.6% fulfilled the criteria for highly active MS. In total, 55 patients treated with NTZ and 23 with FTY demonstrated a significant reduction in relapse rate (NTZ: 95.2%, FTY: 75%), new T2 lesions (NTZ: 97%, FTY: 81%), and contrast-enhancing lesions (NTZ: 97%, FTY: 93%). However, seven patients switched from NTZ to FTY experienced an increase in disease activity. Comparing pediatric MS patients treated in 2005 with those treated in 2015 showed a 46% reduction in relapse rate and a 44% reduction in mean Expanded Disability Status Scale (EDSS).
Conclusion:
The rate of highly active disease among pediatric MS patients is high; more than 40% in our cohort. Response to NTZ and FTY treatment is similar if not better than observed in adults. Current treatment modalities including earlier treatment initiation and the introduction of NTZ and FTY have significantly improved the clinical course of pediatric MS. |
| doi_str_mv | 10.1177/1352458517732843 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1941363324</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1352458517732843</sage_id><sourcerecordid>1941363324</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-3c775fbc0043b72f56f0406148534892818f0abcca865129bfcfbb23e6d8d2ad3</originalsourceid><addsrcrecordid>eNp1kM1Lw0AQxRdRbK3ePUnAi5fo7Fd2c5TiFxS81HPYbHbbLUkTdxMh_71bWhUKnmZgfu_NzEPoGsM9xkI8YMoJ45LHnhLJ6AmaYiZECrmA09jHcbqbT9BFCBsAiBw_RxMic0qjcor4cm286saktcnardb1mCjduy-TdKZyqvdOJ81Q966rTRJ0bXwbXLhEZ1bVwVwd6gx9PD8t56_p4v3lbf64SDXNeJ9SLQS3pQZgtBTE8swCgwwzySmTOZFYWlCl1kpmHJO8tNqWJaEmq2RFVEVn6G7v2_n2czChLxoXtKlrtTXtEAqcM0yz3SsRvT1CN-3gt_G6gmABhGYC8kjBntLxj-CNLTrvGuXHAkOxi7Q4jjRKbg7GQ9mY6lfwk2EE0j0Q1Mr8bf3X8BtlxXwL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2170236709</pqid></control><display><type>article</type><title>Therapy of highly active pediatric multiple sclerosis</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><creator>Huppke, Peter ; Huppke, Brenda ; Ellenberger, David ; Rostasy, Kevin ; Hummel, Hannah ; Stark, Wiebke ; Brück, Wolfgang ; Gärtner, Jutta</creator><creatorcontrib>Huppke, Peter ; Huppke, Brenda ; Ellenberger, David ; Rostasy, Kevin ; Hummel, Hannah ; Stark, Wiebke ; Brück, Wolfgang ; Gärtner, Jutta</creatorcontrib><description>Objective:
Study aims were to determine the frequency of highly active disease in pediatric multiple sclerosis (MS), the response to natalizumab (NTZ) and fingolimod (FTY) treatment, and the impact of current treatment modalities on the clinical course.
Methods:
Retrospective single-center study in the German Center for MS in Childhood and Adolescence.
Results:
Of 144 patients with first MS manifestation between 2011 and 2015, 41.6% fulfilled the criteria for highly active MS. In total, 55 patients treated with NTZ and 23 with FTY demonstrated a significant reduction in relapse rate (NTZ: 95.2%, FTY: 75%), new T2 lesions (NTZ: 97%, FTY: 81%), and contrast-enhancing lesions (NTZ: 97%, FTY: 93%). However, seven patients switched from NTZ to FTY experienced an increase in disease activity. Comparing pediatric MS patients treated in 2005 with those treated in 2015 showed a 46% reduction in relapse rate and a 44% reduction in mean Expanded Disability Status Scale (EDSS).
Conclusion:
The rate of highly active disease among pediatric MS patients is high; more than 40% in our cohort. Response to NTZ and FTY treatment is similar if not better than observed in adults. Current treatment modalities including earlier treatment initiation and the introduction of NTZ and FTY have significantly improved the clinical course of pediatric MS.</description><identifier>ISSN: 1352-4585</identifier><identifier>EISSN: 1477-0970</identifier><identifier>DOI: 10.1177/1352458517732843</identifier><identifier>PMID: 28933245</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adolescent ; Adolescents ; Child ; Children ; Disease Progression ; Female ; Fingolimod Hydrochloride - administration & dosage ; Fingolimod Hydrochloride - pharmacology ; Follow-Up Studies ; Humans ; Immunologic Factors - administration & dosage ; Immunologic Factors - pharmacology ; Immunotherapy ; Magnetic Resonance Imaging ; Male ; Monoclonal antibodies ; Multiple sclerosis ; Multiple Sclerosis - drug therapy ; Multiple Sclerosis - pathology ; Multiple Sclerosis - physiopathology ; Natalizumab - administration & dosage ; Natalizumab - pharmacology ; Outcome Assessment, Health Care ; Patients ; Pediatrics ; Recurrence ; Retrospective Studies ; Severity of Illness Index</subject><ispartof>Multiple sclerosis, 2019-01, Vol.25 (1), p.72-80</ispartof><rights>The Author(s), 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-3c775fbc0043b72f56f0406148534892818f0abcca865129bfcfbb23e6d8d2ad3</citedby><cites>FETCH-LOGICAL-c365t-3c775fbc0043b72f56f0406148534892818f0abcca865129bfcfbb23e6d8d2ad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1352458517732843$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1352458517732843$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21818,27923,27924,43620,43621</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28933245$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huppke, Peter</creatorcontrib><creatorcontrib>Huppke, Brenda</creatorcontrib><creatorcontrib>Ellenberger, David</creatorcontrib><creatorcontrib>Rostasy, Kevin</creatorcontrib><creatorcontrib>Hummel, Hannah</creatorcontrib><creatorcontrib>Stark, Wiebke</creatorcontrib><creatorcontrib>Brück, Wolfgang</creatorcontrib><creatorcontrib>Gärtner, Jutta</creatorcontrib><title>Therapy of highly active pediatric multiple sclerosis</title><title>Multiple sclerosis</title><addtitle>Mult Scler</addtitle><description>Objective:
Study aims were to determine the frequency of highly active disease in pediatric multiple sclerosis (MS), the response to natalizumab (NTZ) and fingolimod (FTY) treatment, and the impact of current treatment modalities on the clinical course.
Methods:
Retrospective single-center study in the German Center for MS in Childhood and Adolescence.
Results:
Of 144 patients with first MS manifestation between 2011 and 2015, 41.6% fulfilled the criteria for highly active MS. In total, 55 patients treated with NTZ and 23 with FTY demonstrated a significant reduction in relapse rate (NTZ: 95.2%, FTY: 75%), new T2 lesions (NTZ: 97%, FTY: 81%), and contrast-enhancing lesions (NTZ: 97%, FTY: 93%). However, seven patients switched from NTZ to FTY experienced an increase in disease activity. Comparing pediatric MS patients treated in 2005 with those treated in 2015 showed a 46% reduction in relapse rate and a 44% reduction in mean Expanded Disability Status Scale (EDSS).
Conclusion:
The rate of highly active disease among pediatric MS patients is high; more than 40% in our cohort. Response to NTZ and FTY treatment is similar if not better than observed in adults. Current treatment modalities including earlier treatment initiation and the introduction of NTZ and FTY have significantly improved the clinical course of pediatric MS.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Child</subject><subject>Children</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Fingolimod Hydrochloride - administration & dosage</subject><subject>Fingolimod Hydrochloride - pharmacology</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immunologic Factors - administration & dosage</subject><subject>Immunologic Factors - pharmacology</subject><subject>Immunotherapy</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Monoclonal antibodies</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - drug therapy</subject><subject>Multiple Sclerosis - pathology</subject><subject>Multiple Sclerosis - physiopathology</subject><subject>Natalizumab - administration & dosage</subject><subject>Natalizumab - pharmacology</subject><subject>Outcome Assessment, Health Care</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><issn>1352-4585</issn><issn>1477-0970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1Lw0AQxRdRbK3ePUnAi5fo7Fd2c5TiFxS81HPYbHbbLUkTdxMh_71bWhUKnmZgfu_NzEPoGsM9xkI8YMoJ45LHnhLJ6AmaYiZECrmA09jHcbqbT9BFCBsAiBw_RxMic0qjcor4cm286saktcnardb1mCjduy-TdKZyqvdOJ81Q966rTRJ0bXwbXLhEZ1bVwVwd6gx9PD8t56_p4v3lbf64SDXNeJ9SLQS3pQZgtBTE8swCgwwzySmTOZFYWlCl1kpmHJO8tNqWJaEmq2RFVEVn6G7v2_n2czChLxoXtKlrtTXtEAqcM0yz3SsRvT1CN-3gt_G6gmABhGYC8kjBntLxj-CNLTrvGuXHAkOxi7Q4jjRKbg7GQ9mY6lfwk2EE0j0Q1Mr8bf3X8BtlxXwL</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Huppke, Peter</creator><creator>Huppke, Brenda</creator><creator>Ellenberger, David</creator><creator>Rostasy, Kevin</creator><creator>Hummel, Hannah</creator><creator>Stark, Wiebke</creator><creator>Brück, Wolfgang</creator><creator>Gärtner, Jutta</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Therapy of highly active pediatric multiple sclerosis</title><author>Huppke, Peter ; Huppke, Brenda ; Ellenberger, David ; Rostasy, Kevin ; Hummel, Hannah ; Stark, Wiebke ; Brück, Wolfgang ; Gärtner, Jutta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-3c775fbc0043b72f56f0406148534892818f0abcca865129bfcfbb23e6d8d2ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Child</topic><topic>Children</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Fingolimod Hydrochloride - administration & dosage</topic><topic>Fingolimod Hydrochloride - pharmacology</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Immunologic Factors - administration & dosage</topic><topic>Immunologic Factors - pharmacology</topic><topic>Immunotherapy</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Monoclonal antibodies</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - drug therapy</topic><topic>Multiple Sclerosis - pathology</topic><topic>Multiple Sclerosis - physiopathology</topic><topic>Natalizumab - administration & dosage</topic><topic>Natalizumab - pharmacology</topic><topic>Outcome Assessment, Health Care</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huppke, Peter</creatorcontrib><creatorcontrib>Huppke, Brenda</creatorcontrib><creatorcontrib>Ellenberger, David</creatorcontrib><creatorcontrib>Rostasy, Kevin</creatorcontrib><creatorcontrib>Hummel, Hannah</creatorcontrib><creatorcontrib>Stark, Wiebke</creatorcontrib><creatorcontrib>Brück, Wolfgang</creatorcontrib><creatorcontrib>Gärtner, Jutta</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Multiple sclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huppke, Peter</au><au>Huppke, Brenda</au><au>Ellenberger, David</au><au>Rostasy, Kevin</au><au>Hummel, Hannah</au><au>Stark, Wiebke</au><au>Brück, Wolfgang</au><au>Gärtner, Jutta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Therapy of highly active pediatric multiple sclerosis</atitle><jtitle>Multiple sclerosis</jtitle><addtitle>Mult Scler</addtitle><date>2019-01</date><risdate>2019</risdate><volume>25</volume><issue>1</issue><spage>72</spage><epage>80</epage><pages>72-80</pages><issn>1352-4585</issn><eissn>1477-0970</eissn><abstract>Objective:
Study aims were to determine the frequency of highly active disease in pediatric multiple sclerosis (MS), the response to natalizumab (NTZ) and fingolimod (FTY) treatment, and the impact of current treatment modalities on the clinical course.
Methods:
Retrospective single-center study in the German Center for MS in Childhood and Adolescence.
Results:
Of 144 patients with first MS manifestation between 2011 and 2015, 41.6% fulfilled the criteria for highly active MS. In total, 55 patients treated with NTZ and 23 with FTY demonstrated a significant reduction in relapse rate (NTZ: 95.2%, FTY: 75%), new T2 lesions (NTZ: 97%, FTY: 81%), and contrast-enhancing lesions (NTZ: 97%, FTY: 93%). However, seven patients switched from NTZ to FTY experienced an increase in disease activity. Comparing pediatric MS patients treated in 2005 with those treated in 2015 showed a 46% reduction in relapse rate and a 44% reduction in mean Expanded Disability Status Scale (EDSS).
Conclusion:
The rate of highly active disease among pediatric MS patients is high; more than 40% in our cohort. Response to NTZ and FTY treatment is similar if not better than observed in adults. Current treatment modalities including earlier treatment initiation and the introduction of NTZ and FTY have significantly improved the clinical course of pediatric MS.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>28933245</pmid><doi>10.1177/1352458517732843</doi><tpages>9</tpages></addata></record> |
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| ispartof | Multiple sclerosis, 2019-01, Vol.25 (1), p.72-80 |
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| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Adolescent Adolescents Child Children Disease Progression Female Fingolimod Hydrochloride - administration & dosage Fingolimod Hydrochloride - pharmacology Follow-Up Studies Humans Immunologic Factors - administration & dosage Immunologic Factors - pharmacology Immunotherapy Magnetic Resonance Imaging Male Monoclonal antibodies Multiple sclerosis Multiple Sclerosis - drug therapy Multiple Sclerosis - pathology Multiple Sclerosis - physiopathology Natalizumab - administration & dosage Natalizumab - pharmacology Outcome Assessment, Health Care Patients Pediatrics Recurrence Retrospective Studies Severity of Illness Index |
| title | Therapy of highly active pediatric multiple sclerosis |
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