Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, University of Toronto, ON, Canada.
Nat Rev Neurol. 2011 Feb;7(2):109-22. doi: 10.1038/nrneurol.2010.198. Epub 2011 Jan 11.
Current and emerging therapies for multiple sclerosis (MS) offer promise for improved disease control and long-term clinical outcome. To date, these therapies have been evaluated solely in the context of adult MS. However, onset of MS in children is being increasingly recognized, and recent studies have identified a significant impact of MS onset during childhood on cognitive and physical functioning. Optimization of pediatric MS care requires that promising new therapies be made available to children and adolescents, but also that safety and tolerability and potential influence of therapies on the developing immune and neural networks of pediatric patients be closely considered. We propose care algorithms illustrating models for therapy that detail careful monitoring of pediatric patients with MS, provide definitions for inadequate treatment response and treatment escalation, and foster multinational collaboration in future therapeutic trials.
目前和新兴的多发性硬化症 (MS) 治疗方法有望改善疾病控制和长期临床结果。迄今为止，这些治疗方法仅在成人 MS 的背景下进行了评估。然而，儿童 MS 的发病正在越来越多地被认识到，最近的研究表明，儿童时期 MS 的发病对认知和身体功能有重大影响。优化儿科 MS 护理需要为儿童和青少年提供有前途的新疗法，同时还需要密切考虑安全性和耐受性以及治疗方法对儿科患者正在发育的免疫和神经网络的潜在影响。我们提出了护理算法，说明了治疗模型，详细说明了对患有 MS 的儿科患者进行仔细监测，为治疗反应不足和治疗升级提供了定义，并促进了未来治疗试验的跨国合作。
