Treatment of multiple sclerosis in children: review of clinical trials

Abstract

Multiple sclerosis (MS) is a rare neuroinflammatory and neurodegenerative disease that leads to disability and a significant decrease in the quality of life. Over the past decade, the focus of studies of MS disease-modifying therapies (DMT) in adults have significantly changed to highly effective drugs at the early stages of the disease; in pediatric patients, safer, but less effective DMTs are preferred. Today, only two DMTs (fingolimod and teriflunomide) investigated over large phase III studies were approved by regulatory authorities for use in children. In recent years, an increasing number of MS children have been receiving highly effective therapy with drugs such as natalizumab, monoclonal antibodies to CD20, monoclonal antibodies to CD52, and autologous hematopoietic stem cell transplantation. These highly effective methods of treatment provide a significant reduction in the inflammatory activity of the disease compared to the first-line DMTs. Therefore, a number of phase II and III studies are currently conducted to assess their efficacy and safety in MS children. This review is related to the basic treatment of MS in pediatric patients, the study of the efficacy and safety of the currently available drugs.