Progress in the Management of Paediatric-Onset Multiple Sclerosis
| Autor: | Adam Kuczynski, Christina Benetou, Ming K. Lim, Hayley Bullock, Sarah R. Rudebeck, Susan Byrne, Katie Hanson, Cheryl Hemingway, Ata Siddiqui, Kshitij Mankad, Sarah Crichton, Aphra Luchesa Smith |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty animal structures Article 03 medical and health sciences 0302 clinical medicine Quality of life 030225 pediatrics medicine relapse Retrospective review business.industry Multiple sclerosis lcsh:RJ1-570 disease-modifying treatment lcsh:Pediatrics medicine.disease Patient management Clinical trial Median time neurodisability Pediatrics Perinatology and Child Health Cohort neurocognitive sense organs demyelination business Neurocognitive 030217 neurology & neurosurgery |
| Zdroj: | Children Volume 7 Issue 11 Children, Vol 7, Iss 222, p 222 (2020) |
| ISSN: | 2227-9067 |
| DOI: | 10.3390/children7110222 |
| Popis: | Considerable progress has been made in the understanding and treatment of paediatric-onset multiple sclerosis (POMS) how this has translated into more effective care is less well understood. Here, we evaluate how recent advances have affected patient management and outcomes with a retrospective review of POMS patients managed at two paediatric neuroimmunology centres. Two cohorts, seen within a decade, were compared to investigate associations between management approaches and outcomes. Demographic, clinical and neurocognitive data were extracted from case notes and analysed. Of 51 patients, 24 were seen during the period 2007&ndash 2010 and 27 during the period 2015&ndash 2016. Median age at onset was 13.7 years time from symptom onset to diagnosis was 9 months. Disease-modifying therapies were commenced in 19 earlier-cohort and 24 later-cohort patients. Median time from diagnosis to treatment was 9 months for earlier vs. 3.5 months in later patients (p = 0.013). A wider variety of treatments were used in the later cohort (four medications earlier vs. seven in the later and two clinical trials), with increased quality of life and neurocognitive monitoring (8% vs. 48% completed PedsQL quality of life inventory 58% vs. 89% completed neurocognitive assessment). In both cohorts, patients were responsive to disease-modifying therapy (mean annualised relapse rate pre-treatment 2.7 vs. 1.7, mean post-treatment 0.74 vs. 0.37 in earlier vs. later cohorts). In conclusion, over the years, POMS patients were treated sooner with a wider variety of medications and monitored more comprehensively. However, this hugely uncontrolled cohort did not allow us to identify key determinants for the improvements observed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|