Multiple sclerosis in childhood: Clinical profile in 125 patients

Duquette, Pierre; Murray, Thomas J.; Pleines, J; Ebers, G. C.; Sadovnick, Dessa; Weldon, P.; Warren, Sharon; Paty, Donald W.; Upton, Arlo; Hader, Walter; Nelson, Robert F.; Auty, Anthony; Neufeld, Branden T.; Meltzer, Carolyn C.

doi:10.1016/s0022-3476(87)80454-7

Cited by 319 publications

(258 citation statements)

References 18 publications

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“…3 On average, MS has a typical onset of disease in young adults at 30 years of age and occurs more frequently in women than men. 4 Like many diseases, MS can present with variable clinical severity. Clinically isolated syndrome (CIS) causes neurological symptoms produced by a single CNS demyelinating lesion.…”

Section: Introductionmentioning

confidence: 99%

Emerging oral immunomodulating agents – focus on teriflunomide for the treatment of multiple sclerosis

Nwankwo¹,

Allington²,

Rivey³

2012

DNND

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Treatment for multiple sclerosis (MS), a chronic disease of the central nervous system, has historically relied exclusively on the use of injectable therapies. As the disease requires lifelong therapy, the development of oral therapies that are safe and effective would provide a more convenient dosage form that may improve patient compliance. One oral medication (fingolimod) was recently approved for treatment of MS. Teriflunomide, an immunomodulator, is one of four oral therapies currently undergoing Phase III trials. Teriflunomide exerts its clinical effects via selective inhibition of de novo pyrimidine synthesis, primarily targeting proliferating T and B lymphocytes in the periphery. Teriflunomide was effective as monotherapy in reducing magnetic resonance imaging lesions and annual relapse rates in Phase II and Phase III trials. When teriflunomide was added to interferon or glatiramer acetate therapy in Phase II trials, teriflunomide reduced magnetic resonance imaging lesions significantly more than either interferon or glatiramer acetate alone. Treatment-emergent adverse events occurred at similar rates among all groups in teriflunomide studies, with a trend towards a higher treatment emergent adverse events rate in the higher dosage group of teriflunomide (14 mg daily). Treatment discontinuations in teriflunomide trials were relatively low, suggesting that teriflunomide monotherapy is well tolerated. This article reviews the mode of action of teriflunomide, its pharmacokinetic, clinical efficacy, and safety profiles.

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Section: Introductionmentioning

confidence: 99%

Emerging oral immunomodulating agents – focus on teriflunomide for the treatment of multiple sclerosis

Nwankwo¹,

Allington²,

Rivey³

2012

DNND

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“…Childhood multiple sclerosis is a rare entity, composing 0.3% to 5.6% of all multiple sclerosis cases [2,8,9]. Duquette et al reported on a cohort of 125 patients with onset of multiple sclerosis before age 16 years [9].…”

Section: Introductionmentioning

confidence: 99%

“…Duquette et al reported on a cohort of 125 patients with onset of multiple sclerosis before age 16 years [9]. The disease course was relapsing-remitting in 56% and initially progressive in 22% of cases.…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis vs acute disseminated encephalomyelitis in childhood

Brass

Caramanos

Santos

et al. 2003

Pediatric Neurology

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“…Generally considered a disease of young and middle-aged adults, an estimated 2.7% to 5.4% of all patients with MS experience their first attack before 18 years of age. [1][2][3][4][5][6][7][8] Initial descriptions of childhood-onset MS appeared in case reports and small case series. [9][10][11][12] Greater awareness and interest led to increased publications, including larger case series, reports from single institutions, multicenter studies, and national and population-based surveys.…”

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confidence: 99%

“…[9][10][11][12] Greater awareness and interest led to increased publications, including larger case series, reports from single institutions, multicenter studies, and national and population-based surveys. [1][2][3][4][5][6][7][8][13][14][15][16][17] Pediatric-onset MS (pediatric MS) was compared with adult-onset MS in a few publications. 5,7,17,18 However, because pediatric MS is a comparatively rare disorder (frequency of 0.2 to 0.64/100 000), 7,[19][20][21][22] most investigations have been limited by relatively small sample sizes, retrospective data, or both.…”

mentioning

confidence: 99%

Characteristics of Children and Adolescents With Multiple Sclerosis

Belman

Krupp

Olsen³

et al. 2016

Pediatrics

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OBJECTIVES: To describe the demographic and clinical characteristics of pediatric multiple sclerosis (MS) in the United States.METHODS: This prospective observational study included children and adolescents with MS. Cases were evaluated across 9 geographically diverse sites as part of the US Network of Pediatric MS Centers. RESULTS:A total of 490 children and adolescents (324 girls, 166 boys) were enrolled; 28% developed symptoms before 12 years of age. The proportion of girls increased with age from 58% (<12 years) to 70% (≥12 years). Race and ethnicity as self-identified were: white, 67%; African American, 21%; and non-Hispanic, 70%. Most (94%) of the cases were born in the United States, and 39% had 1 or both foreign-born parents. Fifty-five percent of cases had a monofocal presentation; 31% had a prodrome (most frequently infectious), most often among those aged <12 years (P < .001). Children aged <12 years presented more commonly with encephalopathy and coordination problems (P < .001). Sensory symptoms were more frequently reported by older children (ie, those aged ≥12 years) (P < .001); 78% of girls had MS onset postmenarche. The initial Expanded Disability Status Scale score for the group was <3.0, and the annualized relapse rate was 0.647 for the first 2 years. Interval from symptom onset to diagnosis and from diagnosis to initiation of disease-modifying therapy was longer among those <12 years of age.CONCLUSIONS: Pediatric MS in the United States is characterized by racial and ethnic diversity, a high proportion of children with foreign-born parents, and differences in clinical features and timing of treatment among those <12 years of age compared with older children. Dr Belman conceptualizated and designed the study in addition to the acquisition of data, analysis, interpretation of the data, and drafting and revising the manuscript; Drs Krupp, Chitnis, Ness, Gorman, and Weinstock-Guttman carried out the acquisition of data, interpretation of data, and revising the manuscript; Mr Olsen carried out the statistical analysis, interpretation of data, and revising the manuscript; Dr Waubant carried out the acquisition of data, design of the study, interpretation of data, and revising the manuscript; Dr Rodriguez carried out acquisition of the data, interpretation of data, and review of the manuscript; Drs Lotze and Aaen carried out WHAT'S KNOWN ON THIS SUBJECT: Pediatric multiple sclerosis has an incidence of ≤0.64 per 10 000 and is less common among those aged <12 years. At onset, it has an almost exclusively relapsing-remitting course. WHAT THIS STUDY ADDS:In the United States, pediatric multiple sclerosis is characterized by racial/ethnic diversity, a high proportion of children with foreign-born parents, and differences in clinical features among those <12 years of age compared with older children.by guest on May 7, 2018 http://pediatrics.aappublications.org/ Downloaded from BELMAN et alMultiple sclerosis (MS) is a central nervous system autoimmune inflammatory demyelinating disease. Generally...

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Multiple sclerosis in childhood: Clinical profile in 125 patients

Cited by 319 publications

References 18 publications

Emerging oral immunomodulating agents – focus on teriflunomide for the treatment of multiple sclerosis

Emerging oral immunomodulating agents – focus on teriflunomide for the treatment of multiple sclerosis

Multiple sclerosis vs acute disseminated encephalomyelitis in childhood

Characteristics of Children and Adolescents With Multiple Sclerosis

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Multiple sclerosis in childhood: Clinical profile in 125 patients

Cited by 319 publications

References 18 publications

Emerging oral immunomodulating agents &ndash; focus on teriflunomide for the treatment of multiple sclerosis

Emerging oral immunomodulating agents &ndash; focus on teriflunomide for the treatment of multiple sclerosis

Multiple sclerosis vs acute disseminated encephalomyelitis in childhood

Characteristics of Children and Adolescents With Multiple Sclerosis

Contact Info

Product

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Emerging oral immunomodulating agents – focus on teriflunomide for the treatment of multiple sclerosis

Emerging oral immunomodulating agents – focus on teriflunomide for the treatment of multiple sclerosis