Abstract Details

Title Changes in Management of Pediatric-onset Multiple Sclerosis: Are We Really Modifying the Disease Course? Data from the Italian MS Registry

Topic Multiple Sclerosis

Presentation(s) S24 - Pregnancy, Pediatric MS, and Early MS (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

Objective to evaluate if disease course of pediatric-onset multiple sclerosis (POMS) has changed over time, with the availability of disease modifying therapies (DMTs).

Background with the exception of fingolimod, all DMTs are currently used off label to treat POMS patients. Many observational studies have shown the clinical efficacy of injectable DMTs, however we lack long-term results after new drugs became available.

Design/Methods we conducted a retrospective observational study using data from the Italian MS registry. Primary endpoints were time to reach a moderate (EDSS ≥4) and severe (EDSS ≥6) disability in patients with POMS across four different diagnostic periods (D1: <1993 [reference]; D2: 1993-1999; D3: 2000-2006; D4: 2007-2014), adjusting for baseline demographics, clinical characteristics and confounders linked to EDSS evaluations. Secondary endpoint was annualized relapse rate (ARR) reduction in the first 6 years of disease.

Results we included 3198 POMS patients: demographics and baseline disease activity were similar across all diagnostic periods. The risk reduction of achieving a moderate (D2: HR 0.69; D3: HR 0.47; D4: HR 0.43; p<0.001) and severe (D2: HR 0.72; D3: HR 0.44; D4: HR 0.30; p<0.01) disability was progressively lower in recent diagnostic epochs. ARR reduction was significantly more evident only in D4. In patients with diagnosis before 18 years (n=1300) the risk reduction was greater for reaching a moderate (D3: HR 0.36, D4: HR0.35; p<0.001) than a severe (D3: HR 0.41, p=0.028; D4: 0.47, p=0.253) disability. ARR was significantly reduced in D3 and D4. All DMTs and high potency drugs were given earlier and to an increasing number of patients with time.

Conclusions disease course of POMS has improved in recent years, probably due to the introduction of new and highly effective DMTs. Having more approved drugs available for children with MS will probably further improve the natural history of the disease.

Authors/Disclosures
Mauro Zaffaroni (Teva Pharma Italia) PRESENTER	No disclosure on file
Damiano Baroncini	No disclosure on file
Pietro Iaffaldano	No disclosure on file
Marta Simone	Marta Simone, 11772 has nothing to disclose.
Vincenzo Brescia Morra, MD (Universita Federico II - Napoli)	Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TEVA. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ALMIRALL. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MERK. Dr. Brescia Morra has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MERK. The institution of Dr. Brescia Morra has received research support from FISM. Dr. Brescia Morra has a non-compensated relationship as a PI with FISM that is relevant to AAN interests or activities.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
	No disclosure on file
Francesco Patti, MD	Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Almirall. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Almirall, Bayer, Biogen, Bristol Meyers and Squibb Merck, Roche, Sanofi, TEVA. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for University of Catania and AISM/FISM, Fondazione Italiana Sclerosi Multipla. Dr. Patti has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology.
Clara Chisari, MD	Clara Chisari, MD has nothing to disclose.
Eleonora Cocco	No disclosure on file
	No disclosure on file
Giuseppe Salemi, MD (Istituto Di Neuropsichiatria)	No disclosure on file
Paolo Ragonese	No disclosure on file
Matilde Inglese, MD, PhD (University of Genoa)	Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SANOFI GENZYME. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Inglese has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for MERCK-SERONO. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MS Journal.
	No disclosure on file
	No disclosure on file
Angelo Ghezzi, MD	No disclosure on file
Damiano Baroncini	No disclosure on file

��ɫ��

��ɫ��