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Abstract Details

Pediatric-onset Multiple Sclerosis in Kuwait
Multiple Sclerosis
P4 - Poster Session 4 (11:45 AM-12:45 PM)
6-009
To determine the demographic and clinical characteristics of pediatric-onset multiple sclerosis (POMS) in Kuwait.
With challenges faced in POMS diagnosis and treatment, epidemiological data and clinical outcomes are limited in the literature.
Using Kuwait national MS registry, a retrospective study was conducted to assess MS patients’, younger than 18 years old, who fulfilled the International Pediatric MS Study Group (IPMSSG) criteria for MS. The demographic data, clinical presentation and treatment strategies were outlined in the study.

Data of 249 Pediatric-onset MS patients were assessed. Mean age at onset and mean disease duration were 15.06 and 11.78 years, respectively. In 10.8% of children, the first symptoms appeared at the age of <12 years. At the last follow-up visits, most of patients (83.5%) remained in a relapsing-remitting phenotype, while 10% had secondary progressive MS (SPMS) and only 1 case (0.4%) was diagnosed as primary progressive MS (PPMS). Twelve patients (4.8%) continued to be labelled as clinical isolated syndrome.

 

The most frequent presentation at onset was of brainstem/cerebellar manifestations, (34.9%), followed by spinal symptoms (29.3%). At the baseline visit, EDSS was 2.26, as compared to the last follow up visit, which significantly decreased to 1.95, (p<0.001). The ARR was 0.18 during the first 2 years while on treatment. About 43.4% of the patients were on interferon/copaxone prior treatment escalation to high efficacy medications. Escalation to high efficacy DMTs was due to disease breakthrough in 36.1% of patients, and 9.6% of others due to adverse events on prior DMT.

POMS has a unique clinical, where brainstem/ cerebellar symptoms was the most frequent first symptoms present. Pediatric patients are less likely to develop PPMS or SPMS and more likely to follow a relapsing–remitting course. Disease breakthrough is common in POMS, especially when using platform therapies.
Authors/Disclosures
Malak AlMojel, MD (Amiri Hospital)
PRESENTER 		Dr. AlMojel has nothing to disclose.
Dalal K. Qasem, MD (Kuwait University) Dr. Qasem has nothing to disclose.
Jasem Y. Al-Hashel, MD (IBN Sina Hospital, AlSabah Medical Area, Neurology Department) Dr. Al-Hashel has nothing to disclose.
Samar F. Ahmed, MD Dr. Ahmed has nothing to disclose.
Raed Alroughani, MD, FAAN Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, AstraZeneca, Novartis, Merck, Roche, Sanofi. Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for AstraZeneca, Biogen, Novartis, Merck, Roche, Sanofi.