Childhood MSers progress slower

Alroughani R, Ahmed S, Al-Hashel J. Paediatric onset multiple sclerosis patients tend to have slower disease progression.
Mult Scler Relat Disord. 2014 3(6):742-3.

BACKGROUND:Data on the difference between pediatric and adult onset multiple sclerosis (MS) in terms of disease course and progression is scare in our region.
OBJECTIVE:To compare the demographic and clinical characteristics between pediatric-onset and adulthood-onset MS.
METHODS:Utilizing the national MS registry, we conducted a cross-sectional study to dichotomize MS patients based on age of disease onset (under 17 years or above). Demographics and clinical characteristics (age, symptoms presentation at onset, disease duration, disease course, relapses, EDSS score, and use of disease modifying therapies) were collected. Simple descriptive statistical tests were used to describe numerical and non-numerical values.
RESULTS:A total of 984 records of MS patients were assessed; of whom 111 (11.3%) had the disease onset before 17 years of age. Paediatric onset MS patients were more likely to be female (female:male ratio 2.5 vs. 1.85; p<0.05), higher brain-stem/cerebellum (36% versus 26%, p<0.03) and multifocal (15.3% versus 8.1%, p<0.01) manifestations at onset. There was no significant difference in the mean EDSS score between the two cohorts (2.51 versus 2.69; p<0.38) or mean number of relapses (3.38 versus 3.05; p<0.14). The time to reach secondary progression MS was longer in the paediatric-onset MS (14.63 versus 11.03 years; p<0.0001). A higher proportion of the paediatric cohort was treated with aggressive therapy (14.4% versus 8.8%; p<0.05) and required earlier escalation therapy (33.3%% versus 27.7%; p<0.04).
CONCLUSIONS:MS patients, who had their disease onset before age 17, tend to be female and have brainstem/cerebellar and multifocal symptoms at disease onset. Despite the comparable relapse rate and disability measures between the two cohorts, patients with paediatric onset had slower disease progression.

Young MSers may convert to secondary progression later after diagnosis than adult MSers. This may be because they also treated more aggressively and have better repair capacities

Young MSers were in the news this week

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