No evidence of disease activity including cognition (NEDA-3 plus) in naïve pediatric multiple sclerosis patients treated with natalizumab

Margoni, Monica; Rinaldi, Francesca; Riccardi, Alice; Franciotta, Silvia; Perini, Paola; Gallo, Paolo

doi:10.1007/s00415-019-09554-z

Cited by 27 publications

(15 citation statements)

References 28 publications

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“…Our clinical validity and population impact results (Table 4, Figure 2), modeled for natalizumab with an adverse event frequency of 1.3% (maximal risk reported by the manufacturer, see Methods), show that at least a quarter of PML cases could be prevented. Natalizumab is a highly effective treatment for many MS patients and some would benefit from its use as a first line therapy, such as those with aggressive or early onset forms of the disease (21,(83)(84)(85). Furthermore, an MRI surveillance study suggests that therapy duration is potentially not a very effective risk stratification factor (8).…”

Section: Discussionmentioning

confidence: 99%

Germline Genetic Risk Variants for Progressive Multifocal Leukoencephalopathy

Eis

Bruno²,

Richmond³

et al. 2020

Front. Neurol.

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Section: Discussionmentioning

confidence: 99%

Germline Genetic Risk Variants for Progressive Multifocal Leukoencephalopathy

Eis

Bruno²,

Richmond³

et al. 2020

Front. Neurol.

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“…No serious adverse effects were reported in this study group. Additionally, a recently published cohort of 20 treatment naïve pediatric MS patients showed that over a treatment period of 24 months with natalizumab, patients had a significant reduction in mean EDSS overall, and NEDA-3 plus status (no evidence of relapse, no disease progression, no new MRI activity, and no cognitive decline) was maintained in 80% of patients, demonstrating natalizumab as a highly effective treatment in pediatric MS [85]. JCV antibodies should be monitored at least every 6 months given the elevated risk of PML in those who are JCV antibody positive, and if seroconversion were to occur, then transitioning to alternative therapy should be considered.…”

Section: Treatment Optionsmentioning

confidence: 97%

Current Advances in Pediatric Onset Multiple Sclerosis

et al. 2020

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Multiple sclerosis (MS) is an autoimmune inflammatory disease affecting the central nervous system leading to demyelination. MS in the pediatric population is rare, but has been shown to lead to significant disability over the duration of the disease. As we have learned more about pediatric MS, there has been a development of improved diagnostic criteria leading to earlier diagnosis, earlier initiation of disease-modifying therapies (DMT), and an increasing number of DMT used in the treatment of pediatric MS. Over time, treatment with DMT has trended towards the initiation of higher efficacy treatment at time of diagnosis to help prevent further disease progression and accrual of disability over time, and there is evidence in current literature that supports this change in treatment patterns. In this review, we discuss the current knowledge in diagnosis, treatment, and clinical outcomes in pediatric MS.

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“…Cognitive issues in pediatric MS have become a research priority in this field, and more studies surrounding cognitive evaluation for these patients were published over the past decade. Although routine cognitive screening is recommended for pediatric MS [ 26 ], and cognition has been incorporated into disease activity measure and treatment consideration [ 5 , 27 , 28 ], the best assessment tools for pediatric MS remain to be determined. Findings yielded by commonly used tools were sometimes discrepant across studies.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Assessment and Rehabilitation for Pediatric-Onset Multiple Sclerosis: A Scoping Review

Lin

Hsu

2020

Children

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Cognitive impairment is increasingly recognized as an important clinical issue in pediatric multiple sclerosis (MS). However, variations regarding its assessment and remediation are noted in clinical arena. This scoping review aims to collate available evidence concerning cognitive assessment tool and cognitive rehabilitation for pediatric MS. We performed a systematic search of electronic databases (MEDLINE, PubMed, CINAHL Plus, and Web of Science) from inception to February 2020. Reference lists of included articles and trial registers were also searched. We included original studies published in English that addressed cognitive assessment tools or cognitive rehabilitation for pediatric-onset MS. Fourteen studies fulfilled our inclusion criteria. Among them, 11 studies evaluated the psychometric aspects of various cognitive assessment tools in the context of pediatric MS, and different neuro-cognitive domains were emphasized across studies. There were only three pilot studies reporting cognitive rehabilitation for pediatric-onset MS, all of which used home-based computerized programs targeting working memory and attention, respectively. Overall, more systematic research on cognitive assessment tools and rehabilitation for pediatric MS is needed to inform evidence-based practice. Computer-assisted cognitive assessment and rehabilitation appear feasible and deserve further studies.

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No evidence of disease activity including cognition (NEDA-3 plus) in naïve pediatric multiple sclerosis patients treated with natalizumab

Cited by 27 publications

References 28 publications

Germline Genetic Risk Variants for Progressive Multifocal Leukoencephalopathy

Germline Genetic Risk Variants for Progressive Multifocal Leukoencephalopathy

Current Advances in Pediatric Onset Multiple Sclerosis

Cognitive Assessment and Rehabilitation for Pediatric-Onset Multiple Sclerosis: A Scoping Review

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