Children with Multiple Sclerosis Recover Better from Relapse than Adults
Original Article
Children with Multiple Sclerosis Recover Better from Relapse than Adults
Ashley Lyles
Children with multiple sclerosis (MS) recover better from relapses than do adults with the condition, according to a study based on data from two longitudinal prospective studies of children and adults with MS.
Prior studies have found that younger age is associated with a higher relapse rate at baseline. In the current analysis, for every 10 years of age, recovery from relapse, as measured by scores on the Expanded Disability Status Scale (EDSS), was reduced by 0.15 points (p<0.0001), the researchers reported in the Journal Brain on August 18.
"Interestingly, not only did paediatric patients recover better but 3-5 fold more paediatric patients experienced a significant improvement in EDSS and functional system scores compared to adults," wrote Tanuja Chitnis, MD, of Massachusetts General Hospital in Boston, and colleagues. "We are not aware of prior studies demonstrating this difference which has implications for further therapeutic development."
"Understanding the mechanisms of age-related recovery from relapse may lead to novel therapeutics that could improve outcomes including relapse-related and disease progression in all patients with multiple sclerosis," they wrote.
For their analysis, the investigators assessed data from 163 pediatric patients with MS from the US Network of Paediatric Multiple Sclerosis Centers (NPMSC) registry; median age at exacerbation was 15.8 years. They also pulled data from 632 adult patients from the Comprehensive Longitudinal Investigations in Multiple Sclerosis at Brigham study, in which the median age at exacerbation was 38.6 years.
The investigators reviewed EDSS scores within one month after an attack and six months after the attack. At follow-up, the change in EDSS compared with scores at baseline was lower in children than in adults (p = 0.001). In addition, a large portion of children had improved EDSS scores after an attack compared to adults (p = 0.006), Moreover, the odds of EDSS not improving went up 1.33-fold for every 10 years of age (p<0.0001), they added.
Limitations include that pediatric patients were from multiple sites, while adult patients were from a single center, the researchers noted. Also, the researchers did not evaluate the age-associated mechanism of relapse recovery, they added.
"This study serves as a basis to investigate age-associated recovery, which may lead to new insights and therapeutic targets for relapse-related disability and progressive multiple sclerosis," the authors concluded.
For more information visit: Chitnis T, Aaen G, BelAman A, et al. Improved relapse recovery in paediatric compared to adult multiple sclerosis. Brain 2020; Epub 2020 Aug 18.
