Clinical and magnetic resonance imaging outcomes in pediatric-onset MS patients on fingolimod and ocrelizumab

Mult Scler Relat Disord. 2024 Jul:87:105647. doi: 10.1016/j.msard.2024.105647. Epub 2024 Apr 26.

Abstract

Background: Observational studies looking at clinical a++nd MRI outcomes of treatments in pediatric MS, could assess current treatment algorithms, and provide insights for designing future clinical trials.

Objective: To describe baseline characteristics and clinical and MRI outcomes in MS patients initiating ocrelizumab and fingolimod under 18 years of age.

Methods: MS patients seen at 12 centers of US Network of Pediatric MS were included in this study if they had clinical and MRI follow-up and started treatment with either ocrelizumab or fingolimod prior to the age of 18.

Results: Eighty-seven patients initiating fingolimod and 52 initiating ocrelizumab met the inclusion criteria. Before starting fingolimod, mean annualized relapse rate was 0.43 (95 % CI: 0.29 - 0.65) and 78 % developed new T2 lesions while during treatment it was 0.12 (95 % CI: 0.08 - 1.9) and 47 % developed new T2 lesions. In the ocrelizumab group, the mean annualized relapse rate prior to initiation of treatment was 0.64 (95 % CI: 0.38-1.09) and a total of 83 % of patients developed new T2 lesions while during treatment it was 0.09 (95 % CI: 0.04-0.21) and none developed new T2 lesions.

Conclusion: This study highlights the importance of evaluating current treatment methods and provides insights about the agents in the ongoing phase III trial comparing fingolimod and ocrelizumab.

Keywords: Fingolimod; MRI outcome; Multiple sclerosis; Ocrelizumab.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Brain / diagnostic imaging
  • Brain / drug effects
  • Brain / pathology
  • Child
  • Female
  • Fingolimod Hydrochloride* / administration & dosage
  • Fingolimod Hydrochloride* / adverse effects
  • Fingolimod Hydrochloride* / therapeutic use
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Magnetic Resonance Imaging*
  • Male
  • Multiple Sclerosis / diagnostic imaging
  • Multiple Sclerosis / drug therapy
  • Treatment Outcome

Substances

  • Fingolimod Hydrochloride
  • ocrelizumab
  • Antibodies, Monoclonal, Humanized
  • Immunologic Factors
  • Immunosuppressive Agents