Department of Clinical and Experimental Medicine, Neurology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, via Roma 67, 56126, Pisa, Italy.
Neurol Sci. 2021 May;42(Suppl 1):5-7. doi: 10.1007/s10072-021-05170-w. Epub 2021 Mar 16.
Pediatric-onset multiple sclerosis (POMS) accounts for approximately 2-10% of all cases of multiple sclerosis (MS) and is associated with higher levels of disease activity than adult-onset MS, including higher rates of clinical relapse and a greater incidence of new T2 lesions on magnetic resonance imaging (MRI). First-line therapy for POMS usually includes interferon β or glatiramer acetate; however, there is limited evidence from randomized trials regarding the safety and efficacy of these disease-modifying drugs in pediatric patients. Fingolimod represents a second-line therapy option for relapsing-remitting MS in pediatric patients. Here, we report the case of a 14-year-old girl with a diagnosis of POMS who started interferon β-1a as first-line therapy and then switched to fingolimod after 12 months due to radiologic progression and clinical relapse. The patient subsequently experienced clinical stability and showed minimal radiologic activity on follow-up MRI. Our case demonstrates the real-world clinical effectiveness and safety of fingolimod in pediatric MS and is in line with the results of previous randomized and observational studies.
儿科发病多发性硬化症（POMS）约占所有多发性硬化症（MS）病例的 2-10%，其疾病活动水平高于成人发病 MS，包括更高的临床复发率和磁共振成像（MRI）上新 T2 病变的更高发生率。POMS 的一线治疗通常包括干扰素β或那他珠单抗；然而，关于这些疾病修正药物在儿科患者中的安全性和疗效，随机试验的证据有限。芬戈莫德是儿科患者复发缓解型 MS 的二线治疗选择。在这里，我们报告了一例 14 岁女孩的病例，该患者被诊断为 POMS，最初接受干扰素β-1a 作为一线治疗，12 个月后因影像学进展和临床复发而改用芬戈莫德。此后，该患者的临床状况稳定，随访 MRI 显示影像学活动最小。我们的病例表明了在儿科 MS 中使用芬戈莫德的真实世界临床疗效和安全性，与之前的随机和观察性研究结果一致。
