Scientists at the Pediatric MS Center at NYU Langone, New York, reported that U.S. adolescents with multiple sclerosis (MS) receiving interferon-beta 1a therapy had a higher body mass index (BMI), more relapses, and were managed differently compared to patients of similar age in seven other countries.
The study, “Subcutaneous interferon β-1a in pediatric patients with multiple sclerosis: Regional differences in clinical features, disease management, and treatment outcomes in an international retrospective study,“ was published in the Journal of the Neurological Sciences.
While there is a consensus that children and adolescents who develop MS should start disease-modifying therapy as soon as possible, not much is known about how children react to these therapies, or how their disease is managed across countries.
A recent study of 298 children and adolescents with MS from the U.S., Italy, Russia, Argentina, France, Canada, Tunisia, and Venezuela found that children on interferon-beta 1a therapy tolerated adult doses of the drug well, concluding that the treatment reduced relapse rates.
In the new study, the same research team analyzed if treatment management and outcomes differed between children in the U.S. and those in the other seven countries. Patients in the U.S. constituted 44 percent of the total sample.
When the researchers divided the group, taking into account children below the age of 12 and adolescents ages 12–17, they noted that U.S. adolescents had a higher average BMI than adolescents from the other countries. But this could only be confirmed in a proportion of the patients, since information on BMI was only available for 41 percent of U.S. and 15 percent of participants from the other countries.
The findings also indicated that U.S. participants in both age groups had higher relapse rates than other participants. The time between the start of interferon treatment and first relapse also was shorter in the U.S. children.
Children and adolescents in the U.S. received disease-modifying treatment earlier than children elsewhere, and a larger proportion of them had already tried treatment with another disease-modifying drug before starting interferon therapy. They were also more likely to switch from interferon to another treatment during the study.
While these data are alarming, they need to be confirmed in larger studies with the possibility of following MS patients over time. Particularly, analyses of why clinical management differs between the U.S. and other countries, and reasons for more rapid drug switching in the U.S., might lead to improved management.
Findings of higher BMI in this group of MS patients also need to be confirmed, as it is crucial to focus on interventions for MS adolescents who are at risk of becoming obese to prevent further comorbidities.
Magdalena Kegel
