Natalizumab in children

#MSBlog: Children with MS respond very well to Natalizumab. Good news for anxious parents!

Epub: Ghezzi et al. Nataluzimab in pediatric multiple sclerosis: results of a cohort of 55 cases. Mult Scler. 2013 Feb 11.

BACKGROUND: Limited information is available on the use of natalizumab (NA) in pediatric MSers (ped-MSers).

OBJECTIVE: The purpose of this study was to describe the long-term effects of NA in a large cohort of active ped-MSers.

METHODS: Ped-MSers were treated with NA if in the previous year they had experienced at least two relapses or a severe relapse with incomplete recovery while on immunomodulating treatment, or at least two relapses and new magnetic resonance imaging (MRI) lesions regardless of any prior treatment.

RESULTS: The study included 55 ped-MSers (mean age: 14.4 years, mean number of relapses: 4.4, pre-treatment mean disease duration: 25.5 months). They received a median number of 26 infusions. Three relapses occurred during the follow-up, one female ped-MSer continued to deteriorate in cognitive functioning. Mean Expanded Disability Status Scale (EDSS) scores decreased from 2.7 to 1.9 at the last visit (p<0.001). During the follow-up the majority of ped-MSers remained free from MRI activity. Transient and mild clinical adverse events occurred in 20 ped-MSers . Mild hematological abnormalities occurred in seven ped-MSers. Anti-JCV antibodies were detected in 20/51 tested ped-MSers.

CONCLUSIONS: NA was well tolerated in all ped-MSers. A strong suppression of disease activity was observed in the majority of ped-MSers during the follow-up.

"This study is very good news for anxious parents of children with active MS. Natalizumab works as well in children as it does in adults. We must assume the risks are the same, i.e. the PML risk."

CoI: multiple

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