Current and Emerging Treatment Options in Pediatric Onset Multiple Sclerosis
Mavridi, Artemis; Bompou, Maria Eleni; Redmond, Áine; Archontakis-Barakakis, Paraschos; Vavougios, George D.; Mitsikostas, Dimos D.; Mavidis, Theodoros
Pediatric onset multiple sclerosis (POMS), characterized by the onset of multiple sclerosis
before the age of 18, is gaining increased recognition. Approximately 5 percent of MS cases manifest
before the age of 18, with less than 1 percent occurring before the age of 10. Despite its rarity,
pediatric MS exhibits distinct characteristics, with an association between younger age at onset and a
comparatively slower disease progression. Despite this slower progression, individuals with POMS
historically reach disability milestones at earlier ages than those with adult-onset multiple sclerosis.
While various immunomodulatory agents demonstrate significant benefits in MS treatment, such as
reduced relapse rates and slower accumulation of brain lesions on magnetic resonance imaging (MRI),
the majority of disease-modifying therapies (DMTs) commonly used in adult MS lack evaluation
through pediatric clinical trials. Current evidence is predominantly derived from observational
studies. This comprehensive review aims to consolidate existing knowledge on the mechanisms
of action, efficacy, safety profiles, and recommended dosages of available DMTs specifically in the
context of pediatric MS. Furthermore, this review outlines recent advancements and explores potential
medications still in developmental stages, providing a thorough overview of the current landscape
and future prospects for treating POMS.
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