TyPed study: Natalizumab for the treatment of pediatric-onset multiple sclerosis in Portugal

Filipe Palavra, Sónia Figueiroa, Ana Sofia Correia, Fernando Tapadinhas, João Cerqueira, Rui Pedro Guerreiro, João de Sá, Maria José Sá, Sofia Almeida, Patrícia Mota, Lívia Sousa

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A significant proportion of pediatric-onset multiple sclerosis (POMS) patients do not respond to first-line disease-modifying therapies. Clinical trials showed that natalizumab is effective and safe in adults, but there are limited clinical trial data for children. Natalizumab is currently prescribed off-label for POMS. We aimed to characterize the effectiveness, safety and tolerability of natalizumab in all POMS cases treated in Portugal (from 2007 to 2018). Methods: Data from clinical records were retrospectively collected for all POMS cases treated with natalizumab in Portugal. Results: Twenty-one patients were included, 14 (67%) of which were female. The median age at POMS diagnosis was 13 years old. The median duration of treatment with natalizumab was 2 years and 3 months. Median Expanded Disability Status Scale score decreased from 1.5 to 1.0 after 24 months. The Annualized Relapse Rate decreased from 1.31 events/patient/year before treatment with natalizumab to 0 after 12 months of treatment and to 0.04 after 24 months. No gadolinium-enhancing lesions or new or enlarged T2 hyperintense lesions were observed in 8/8 patients (100%) after 12 months, and 4/5 (80%) after 24 months. There was one possible serious adverse event, which did not require dose adjustment. Five patients discontinued treatment due to positive anti-JCV (JC virus) antibody JC serostatus. Conclusion: Natalizumab may be an effective and safe disease-modifying therapy for POMS. Our results are in line with data published for the adult population, as well as with similar observational studies in pediatric populations in other regions.

Original languageEnglish
Article number102865
JournalMULTIPLE SCLEROSIS AND RELATED DISORDERS
Volume51
DOIs
Publication statusPublished - Jun 2021

Keywords

  • DMT
  • Multiple sclerosis
  • Natalizumab
  • Pediatric
  • POMS
  • Portugal

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