Researchers from the National Network of Pediatric MS Centers of Excellence, in the first retrospective study of the response of children with multiple sclerosis to standard, or first-line, therapies, found that one-fifth of patients involved in the review required “second-line” treatments.
Results of the study, published online first in the December 2010 issue of the Archives of Neurology, also reported that Hispanic children with MS were more likely to experience “break-through disease” while receiving first-line therapies than non-Hispanic children.
E. Ann Yeh, UB assistant professor of neurology, is first author. In addition to UB, the National Network of Pediatric MS Centers includes Stony Brook University, University of California-San Francisco, University of Alabama-Birmingham, The Mayo Clinic and Massachusetts General Hospital.
The review of data covering the records of 243 children treated an average of 3.9 years showed that 144 (58 percent) stayed on their first therapy, primarily interferon beta, 65 (25.2 percent) were switched to one other therapy, 29 (11.2 percent) were switched twice and 20 (7.8 percent) were switched three times.
While most children switched to other first-line MS drugs, 55 children, or 21.3 percent had to be switched to a variety of “second-line” drugs, such as broad spectrum chemotherapies and corticosteroids, results showed. These children had shown MS relapses or new brain lesions detected on MRI scans.
“Multiple papers on the use of first-line therapies in the pediatric MS population have been published over the past 10 years,” says Yeh, “and the use of first-line therapies in this population has come to be accepted as relatively safe. In practice, however, we were seeing more and more children who continued to have very active disease despite use of first-line therapies.
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