Neurology Unit, Guglielmo da Saliceto Civil Hospital, Via Giuseppe Taverna 49, 29121, Piacenza, Italy.
Neurology Unit, San Giacomo Hospital, ASL AL, Novi Ligure, Italy.
Neurol Sci. 2021 May;42(Suppl 1):15-18. doi: 10.1007/s10072-021-05058-9. Epub 2021 Jan 19.
Treatment of pediatric multiple sclerosis (MS) has been increasingly debated in the last few years due to limited knowledge of treatment strategies and therapeutic options. When MS develops at a young age, it usually has a very inflammatory disease course, with many relapses and disease activity as seen in magnetic resonance imaging (MRI). Therefore, treatment with immunomodulatory drugs may be beneficial in these patients. However, limited data are available to date on the treatment of pediatric MS. Although observational, prospective, and retrospective studies provide some information on its treatment course, only one clinical trial in pediatric patients has been published, the PARADIGMS trial, which showed an 82% reduction in relapse rate with fingolimod (0.5 mg/day) versus interferon β-1a (30 μg once weekly intramuscularly). Here, we present the case of a pediatric patient with MS (age of onset, 13 years), who was initially treated with interferon β-1a for 2 years and subsequently switched to fingolimod, owing to clinical and radiological activity despite treatment with interferon β-1a.
由于对治疗策略和治疗选择的了解有限，过去几年中，儿科多发性硬化症（MS）的治疗方法一直备受争议。当 MS 在年轻时发病时，其疾病过程通常具有很强的炎症性，磁共振成像（MRI）上可见许多复发和疾病活动。因此，免疫调节药物治疗可能对这些患者有益。然而，目前关于儿科 MS 的治疗方法的数据有限。尽管观察性、前瞻性和回顾性研究提供了一些关于其治疗过程的信息，但只有一项在儿科患者中进行的临床试验——PARADIGMS 试验发表，该试验显示与干扰素 β-1a（30μg 每周一次肌内注射）相比， fingolimod（0.5mg/天）可使复发率降低 82%。在此，我们介绍了一例儿科 MS 患者（发病年龄 13 岁）的病例，该患者最初接受干扰素 β-1a 治疗 2 年，随后因临床和影像学活动而改用 fingolimod，尽管干扰素 β-1a 治疗。
