Abstract Details

Title Features of Pediatric Multiple Sclerosis: Demographics, Phenotypes, and Treatments in a Cohort of 139 Patients at a Tertiary Center

Topic Multiple Sclerosis

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 20-004

Objective

To characterize the pediatric multiple sclerosis (MS) population at our center, including demographics, clinical presentations, diagnostic features, treatments, and outcomes.

Background Multiple sclerosis is an immune-mediated demyelinating disorder of the central nervous system involving the brain, spinal cord, and optic nerves. Onset before age 18 is uncommon, and pediatric MS demonstrates distinct clinical and therapeutic characteristics compared to adult-onset MS. Disease-modifying therapies (DMTs) are not as extensively studied in children and presently there is only one FDA-approved pediatric DMT.

Design/Methods We performed a retrospective chart review of patients diagnosed with MS before age 18, between 2009 and 2024. Individual chart review included provider documentation, imaging and laboratory results, and medication histories. Data were compiled into a secure database and summarized descriptively by using standardized statistical metrics.

Results A total of 139 patients were identified (female = 96, male = 42). The mean age at diagnosis was 13.9 years (range 2–17, median 15). Among younger patients (ages 2–4), motor deficits and ataxia were the predominant presenting symptoms, whereas older patients (ages 11–17) more commonly presented with sensory or visual symptoms. Of patients receiving DMTs (n = 130, 93.5%), 49.2% remained on their initial regimen, while 33.8% required one switch and 16.9% underwent multiple regimen changes. Over time, DMT selection shifted from injectable to oral and intravenous agents. Patients started on newer, higher efficacy DMTs were less likely to relapse or discontinue due to side effects or adherence issues.

Conclusions Although MS is primarily an adult disease, it can present in children with age-dependent symptom patterns. Over the past two decades, our center’s treatment approach has evolved toward oral and intravenous DMTs, correlating with improved treatment stability and reduced switching frequency.

Authors/Disclosures
Benjamin M. Greenberg, MD, FAAN (UT Southwestern Medical Center) PRESENTER	Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Greenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Greenberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Greenberg has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Sanofi/Genzyme. Dr. Greenberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant. Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for IQVIA. Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Greenberg has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Clene. Dr. Greenberg has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for IQVIA. Dr. Greenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abcuro. Dr. Greenberg has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Siegel Rare Neuroimmune Association. Dr. Greenberg has or had stock in GenrAb.Dr. Greenberg has or had stock in Clene.Dr. Greenberg has received intellectual property interests from a discovery or technology relating to health care. Dr. Greenberg has received publishing royalties from a publication relating to health care.
Isabella Strozzi, MD (Children's Medical Center)	Dr. Strozzi has nothing to disclose.
Lana Harder, PhD (Children'S Medical Center, Dallas/UT Southwestern)	Dr. Harder has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ionis Pharmaceuticals.
Linda Nguyen, MD, PhD (UT Southwestern Medical Center)	Dr. Nguyen has nothing to disclose.
Darina Dinov, DO	Dr. Dinov has nothing to disclose.
Tricia Plumb, RN	Ms. Plumb has nothing to disclose.
Denise Maddox, RN	Ms. Maddox has nothing to disclose.
Cynthia X. Wang, MD (Children's Dallas Neurology)	Dr. Wang has nothing to disclose.

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