Current international trends in the treatment of multiple sclerosis in children:  impact of the COVID-19 pandemic

Fredrik Sandesjö; Evangeline Wassmer; Kumaran Deiva; Maria Pia Amato; Tanuja Chitnis; Cheryl Hemingway; Lauren Krupp; Daniela Pohl; Kevin Rostasy; Emanuelle Waubant; Brenda Banwell; Ronny Wickström

doi:10.1016/j.msard.2021.103277

Current international trends in the treatment of multiple sclerosis in children: impact of the COVID-19 pandemic

Fredrik Sandesjö, Evangeline Wassmer, Kumaran Deiva, Maria Pia Amato, Tanuja Chitnis, Cheryl Hemingway, Lauren Krupp, Daniela Pohl, Kevin Rostasy, Emanuelle Waubant, Brenda Banwell, Ronny Wickström^*

^*Corresponding author for this work

School of Biosciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice.

Methods: We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases.

Results: The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic.

Conclusions: The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.

Original language	English
Article number	103277
Journal	Multiple Sclerosis and Related Disorders
Volume	56
Early online date	27 Sept 2021
DOIs	https://doi.org/10.1016/j.msard.2021.103277
Publication status	Published - Nov 2021

Bibliographical note

© 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license

Funding: Financial support without any role in the design and conduct of this study was obtained from Stockholm City Council, Stiftelsen Barnforskningen vid Astrid Lindgrens Barnsjukhus and Sällskapet Barnavård.

Keywords

COVID-19
MS
pediatric disease
modifying therapy

Access to Document

10.1016/j.msard.2021.103277Licence: CC BY 3.0

VoR- Current international trends in the treatment of multiple sclerosis in children
© 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license
Final published version, 1.97 MBLicence: CC BY 3.0

Cite this

Sandesjö, F., Wassmer, E., Deiva, K., Amato, M. P., Chitnis, T., Hemingway, C., Krupp, L., Pohl, D., Rostasy, K., Waubant, E., Banwell, B., & Wickström, R. (2021). Current international trends in the treatment of multiple sclerosis in children: impact of the COVID-19 pandemic. Multiple Sclerosis and Related Disorders, 56, Article 103277. https://doi.org/10.1016/j.msard.2021.103277

@article{4ba874ff894b4015ab67f9eab450cbaf,

title = "Current international trends in the treatment of multiple sclerosis in children: impact of the COVID-19 pandemic",

abstract = "Background: Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice.Methods: We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases.Results: The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic.Conclusions: The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.",

keywords = "COVID-19, MS, pediatric disease, modifying therapy",

author = "Fredrik Sandesj{\"o} and Evangeline Wassmer and Kumaran Deiva and Amato, {Maria Pia} and Tanuja Chitnis and Cheryl Hemingway and Lauren Krupp and Daniela Pohl and Kevin Rostasy and Emanuelle Waubant and Brenda Banwell and Ronny Wickstr{\"o}m",

note = "{\textcopyright} 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license Funding: Financial support without any role in the design and conduct of this study was obtained from Stockholm City Council, Stiftelsen Barnforskningen vid Astrid Lindgrens Barnsjukhus and S{\"a}llskapet Barnav{\aa}rd.",

year = "2021",

month = nov,

doi = "10.1016/j.msard.2021.103277",

language = "English",

volume = "56",

}

TY - JOUR

T1 - Current international trends in the treatment of multiple sclerosis in children

T2 - impact of the COVID-19 pandemic

AU - Sandesjö, Fredrik

AU - Wassmer, Evangeline

AU - Deiva, Kumaran

AU - Amato, Maria Pia

AU - Chitnis, Tanuja

AU - Hemingway, Cheryl

AU - Krupp, Lauren

AU - Pohl, Daniela

AU - Rostasy, Kevin

AU - Waubant, Emanuelle

AU - Banwell, Brenda

AU - Wickström, Ronny

N1 - © 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license Funding: Financial support without any role in the design and conduct of this study was obtained from Stockholm City Council, Stiftelsen Barnforskningen vid Astrid Lindgrens Barnsjukhus and Sällskapet Barnavård.

PY - 2021/11

Y1 - 2021/11

N2 - Background: Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice.Methods: We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases.Results: The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic.Conclusions: The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.

AB - Background: Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice.Methods: We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases.Results: The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic.Conclusions: The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.

KW - COVID-19

KW - MS

KW - pediatric disease

KW - modifying therapy

UR - https://linkinghub.elsevier.com/retrieve/pii/S2211034821005447

U2 - 10.1016/j.msard.2021.103277

DO - 10.1016/j.msard.2021.103277

M3 - Article

C2 - 34624643

SN - 2211-0348

VL - 56

JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

M1 - 103277

ER -