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Pediatric-onset Multiple Sclerosis treatment: a multicentre observational study comparing natalizumab with fingolimod.
Carotenuto, Antonio; Di Monaco, Cristina; Papetti, Laura; Borriello, Giovanna; Signoriello, Elisabetta; Masciulli, Camilla; Tomassini, Valentina; De Luca, Giovanna; Ianniello, Antonio; Lus, Giacomo; Novarella, Federica; Spiezia, Antonio Luca; Di Somma, Dario; Moccia, Marcello; Petracca, Maria; Iacovazzo, Carmine; Servillo, Giuseppe; Portaccio, Emilio; Triassi, Maria; Amato, Maria Pia; Pozzilli, Carlo; Valeriani, Massimiliano; Brescia Morra, Vincenzo; Lanzillo, Roberta.
Afiliación
  • Carotenuto A; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy. carotenuto.antonio87@gmail.com.
  • Di Monaco C; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy.
  • Papetti L; Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Borriello G; Department of Public Health, University "Federico II" of Naples, Naples, Italy.
  • Signoriello E; Second Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania, Naples, Italy.
  • Masciulli C; Department of NEUROFARBA, University of Florence, Florence, Italy.
  • Tomassini V; Multiple Sclerosis Centre, Clinical Neurology, SS. Annunziata University Hospital, Chieti, Italy.
  • De Luca G; Institute for Advanced Biomedical Technologies (ITAB), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
  • Ianniello A; Multiple Sclerosis Centre, Clinical Neurology, SS. Annunziata University Hospital, Chieti, Italy.
  • Lus G; Department of Human Neurosciences, Sapienza University, Rome, Italy.
  • Novarella F; Second Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania, Naples, Italy.
  • Spiezia AL; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy.
  • Di Somma D; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy.
  • Moccia M; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy.
  • Petracca M; Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy.
  • Iacovazzo C; Department of Human Neurosciences, Sapienza University, Rome, Italy.
  • Servillo G; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy.
  • Portaccio E; Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University, Naples, Italy.
  • Triassi M; Department of NEUROFARBA, University of Florence, Florence, Italy.
  • Amato MP; Department of Public Health, University "Federico II" of Naples, Naples, Italy.
  • Pozzilli C; Department of NEUROFARBA, University of Florence, Florence, Italy.
  • Valeriani M; Department of Human Neurosciences, Sapienza University, Rome, Italy.
  • Brescia Morra V; Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Lanzillo R; System Medicine Department, Tor Vergata University of Rome, Rome, Italy.
J Neurol ; 271(10): 6773-6781, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39177751
ABSTRACT

BACKGROUND:

Pediatric-onset Multiple Sclerosis (POMS) patients show more inflammatory disease compared with adult-onset MS. However, highly effective treatments are limited with only fingolimod being approved in Italy and natalizumab prescribed as off-label treatment.

OBJECTIVES:

to compare the efficacy of natalizumab versus fingolimod in POMS.

METHODS:

This is an observational longitudinal multicentre study including natalizumab- and fingolimod-treated POMS patients (N-POMS and F-POMS, respectively). We collected Annual Relapse Rate (ARR), Expanded Disability Status Scale (EDSS), Symbol Digit Modality Test (SDMT), and MRI activity at baseline (T0), 12-18 months (T1), and last available observation (T2).

RESULTS:

We enrolled 57 N-POMS and 27 F-POMS patients from six Italian MS Centres. At T0, N-POMS patients showed higher ARR (p = 0.03), higher EDSS (p = 0.003) and lower SDMT (p = 0.04) at baseline compared with F-POMS. Between T0 and T1 ARR improved for both N-POMS and F-POMS (p < 0.001), while EDSS (p < 0.001) and SDMT (p = 0.03) improved only for N-POMS. At T2 (66.1 ± 55.4 months) we collected data from 42 out of 57 N-POMS patients showing no further ARR decrease.

CONCLUSION:

Both natalizumab and fingolimod showed high and sustained efficacy in controlling relapses and natalizumab also associated to a disability decrease in POMS. This latter effect might be partly mediated by the high inflammatory activity at baseline in N-POMS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clorhidrato de Fingolimod / Natalizumab / Factores Inmunológicos / Esclerosis Múltiple Límite: Adolescent / Child / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: J Neurol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clorhidrato de Fingolimod / Natalizumab / Factores Inmunológicos / Esclerosis Múltiple Límite: Adolescent / Child / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: J Neurol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania