Moving on to second-line therapies in pediatric MS

Abstract

Pediatric onset multiple sclerosis (POMS) is thought to represent up to 5% of all cases of multiple sclerosis (MS). Onset of MS below 18 years of age has been associated with more frequent relapses,1 thus suggesting a more highly inflammatory course than is seen in adult-onset disease. Further, long-term follow-up data on individuals with pediatric onset MS suggests better recovery from relapses and a longer time to conversion to progressive disease. Despite this, secondary progressive MS occurs in patients with POMS at an average age 10 years younger than those diagnosed with MS as adults.2 As such, gaining knowledge regarding interventions that will change the disease course in POMS is critical. The last decade has been characterized by the discovery of effective therapies that can alter the natural history of MS in adults. Despite the pathologic heterogeneity associated with MS lesions, the prevailing hypothesis regarding MS pathogenesis is that it is due to an abnormal peripheral autoimmune process in which autoreactive T lymphocytes orchestrate a complex cascade of events involving the …