Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486 |
Resumo: | Introduction: Pediatric-onset multiple sclerosis may contrast with adult-onset multiple sclerosis, in terms of disease activity. We aimed to determine differentiating features between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis, at diagnosis and after one year under disease modifying therapies, and analyse the attainment of the status of “No Evidence of Disease Activity” between groups.Material and Methods: We analyzed demographical, laboratory, clinical and imaging features of patients with relapsing-remitting multiple sclerosis diagnosed at our center, according to the McDonald’s 2010 criteria, with ≥ 1 year under disease modifying therapies and with available magnetic resonance imaging scans at diagnosis and one year after disease modifying therapies initiation. Patients were paired according to gender and disease modifying therapies in use. “No Evidence of Disease Activity” status was assessed, and differences were studied.Results: Fifteen pediatric-onset multiple sclerosis (aged ≥ 8 and < 18 years) and 15 adult-onset multiple sclerosis (≥ 18 and < 55 years) patients were recruited. We found a statistically significant difference in the number of T2 weighted image diffuse lesions/with poorly defined borders (p = 0.015). The mean expanded disability status scale score after one year under disease modifying therapies was lower in the pediatric-onset multiple sclerosis group (1.6 ± 0.8) compared to the adult-onset multiple sclerosis group (2.3 ± 0.8; p = 0.032). Nevertheless, no differences were found regarding the percentage of cases achieving “No Evidence of Disease Activity” in either group.Discussion: Although there is an empirical impression about the difference in inflammatory activity between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis, it was not possible to corroborate it in our study. Nevertheless, this was an exploratory and retrospective analysis of a small sample of patients, identifying variables in which such differences appear to be most important.Conclusion: Extensive studies of children, adolescents and adults with multiple sclerosis will be needed to categorize the clinical and radiological differences that allow the identification of drug response biomarkers in the early stages of the disease. |
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Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After DiagnosisAtividade Inflamatória e Resposta ao Tratamento na Esclerose Múltipla Pediátrica, em Comparação com o Adulto: Estudo Piloto, Retrospetivo e Observacional do Primeiro Ano Após o DiagnósticoChildMagnetic Resonance ImagingMultiple SclerosisRelapsingCriançaEsclerose MúltiplaEsclerose Múltipla Recidivante-RemitenteRessonância MagnéticaIntroduction: Pediatric-onset multiple sclerosis may contrast with adult-onset multiple sclerosis, in terms of disease activity. We aimed to determine differentiating features between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis, at diagnosis and after one year under disease modifying therapies, and analyse the attainment of the status of “No Evidence of Disease Activity” between groups.Material and Methods: We analyzed demographical, laboratory, clinical and imaging features of patients with relapsing-remitting multiple sclerosis diagnosed at our center, according to the McDonald’s 2010 criteria, with ≥ 1 year under disease modifying therapies and with available magnetic resonance imaging scans at diagnosis and one year after disease modifying therapies initiation. Patients were paired according to gender and disease modifying therapies in use. “No Evidence of Disease Activity” status was assessed, and differences were studied.Results: Fifteen pediatric-onset multiple sclerosis (aged ≥ 8 and < 18 years) and 15 adult-onset multiple sclerosis (≥ 18 and < 55 years) patients were recruited. We found a statistically significant difference in the number of T2 weighted image diffuse lesions/with poorly defined borders (p = 0.015). The mean expanded disability status scale score after one year under disease modifying therapies was lower in the pediatric-onset multiple sclerosis group (1.6 ± 0.8) compared to the adult-onset multiple sclerosis group (2.3 ± 0.8; p = 0.032). Nevertheless, no differences were found regarding the percentage of cases achieving “No Evidence of Disease Activity” in either group.Discussion: Although there is an empirical impression about the difference in inflammatory activity between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis, it was not possible to corroborate it in our study. Nevertheless, this was an exploratory and retrospective analysis of a small sample of patients, identifying variables in which such differences appear to be most important.Conclusion: Extensive studies of children, adolescents and adults with multiple sclerosis will be needed to categorize the clinical and radiological differences that allow the identification of drug response biomarkers in the early stages of the disease.Introdução: A esclerose múltipla de início em idade pediátrica pode contrastar com a esclerose múltipla de início na idade adulta, em termos de atividade da doença. Pretendemos determinar características diferenciadoras entre esclerose múltipla de início em idade pediátrica e esclerose múltipla de início na idade adulta ao diagnóstico e um ano após o início de terapêuticas modificadoras da doença e analisar o atingimento do estado de “Ausência de Evidência de Atividade de Doença”.Material e Métodos: Analisámos as características demográficas, laboratoriais, clínicas e imagiológicas de doentes com esclerose múltipla surto-remissão diagnosticados no nosso centro, segundo os critérios de McDonald 2010, com ≥ 1 ano sob terapêuticas modificadoras de doença e com ressonâncias magnéticas disponíveis no diagnóstico e um ano após o início de terapêuticas modificadoras da doença. Os doentes foram emparelhados de acordo com o género e terapêuticas em uso. O estado de “Ausência de Evidência de Atividade de Doença” foi avaliado e as diferenças estudadas.Resultados: Quinze doentes com esclerose múltipla de início em idade pediátrica (≥ 8 e < 18 anos de idade) e 15 com esclerose múltipla de início na idade adulta (≥ 18 e < 55 anos de idade) foram recrutados para este estudo. Encontrámos uma diferença estatisticamente significativa no número de lesões difusas/com bordos mal definidos ponderadas em T2 (p = 0,015). A pontuação média da escala expandida de incapacidade após um ano sob a respetiva terapêutica modificadora de doença foi menor no grupo esclerose múltipla de início em idade pediátrica (1,6 ± 0,8) em comparação com o grupo esclerose múltipla de início na idade adulta (2,3 ± 0,8; p = 0,032). Ainda assim, não se encontraram diferenças relativamente à percentagem de casos alcançando “Ausência de Evidência de Atividade de Doença” em ambos os grupos.Discussão: Apesar de existir uma impressão empírica sobre uma diferença de atividade inflamatória entre a esclerose múltipla de início em idade pediátrica e a esclerose múltipla de início na idade adulta, não foi possível corroborá-la no nosso estudo. De qualquer modo, esta foi uma análise exploratória e retrospetiva de uma amostra pequena de doentes, em que identificámos as variáveis em que tais diferenças parecem ser mais importantes.Conclusão: Estudos alargados de crianças, adolescentes e adultos com esclerose múltipla serão necessários para categorizar as diferenças clínicas e radiológicas que permitam identificar biomarcadores de resposta a fármacos, em fases precoces da doença.Ordem dos Médicos2021-01-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfimage/jpegimage/jpegimage/jpegimage/jpegimage/pngimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegimage/jpegapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/mswordimage/jpegimage/jpegimage/jpegapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486oai:ojs.www.actamedicaportuguesa.com:article/12486Acta Médica Portuguesa; Vol. 34 No. 1 (2021): January; 28-34Acta Médica Portuguesa; Vol. 34 N.º 1 (2021): Janeiro; 28-341646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/6196https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11598https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11599https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11610https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11611https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11612https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11613https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11614https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11664https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11665https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11666https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11667https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11668https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11669https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11670https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11671https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11700https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12167https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12177https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12178https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12179https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12419Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessde Carvalho, SaraPinto, JoanaCorreia, InêsFaustino, RicardoVasconcelos, MónicaSousa, LíviaPalavra, Filipe2022-12-20T11:06:37Zoai:ojs.www.actamedicaportuguesa.com:article/12486Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:11.837205Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis Atividade Inflamatória e Resposta ao Tratamento na Esclerose Múltipla Pediátrica, em Comparação com o Adulto: Estudo Piloto, Retrospetivo e Observacional do Primeiro Ano Após o Diagnóstico |
title |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis |
spellingShingle |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis de Carvalho, Sara Child Magnetic Resonance Imaging Multiple Sclerosis Relapsing Criança Esclerose Múltipla Esclerose Múltipla Recidivante-Remitente Ressonância Magnética |
title_short |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis |
title_full |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis |
title_fullStr |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis |
title_full_unstemmed |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis |
title_sort |
Inflammatory Activity and Treatment Response in Pediatric Compared to Adult Multiple Sclerosis: A Pilot, Retrospective and Observational Study of the First Year After Diagnosis |
author |
de Carvalho, Sara |
author_facet |
de Carvalho, Sara Pinto, Joana Correia, Inês Faustino, Ricardo Vasconcelos, Mónica Sousa, Lívia Palavra, Filipe |
author_role |
author |
author2 |
Pinto, Joana Correia, Inês Faustino, Ricardo Vasconcelos, Mónica Sousa, Lívia Palavra, Filipe |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
de Carvalho, Sara Pinto, Joana Correia, Inês Faustino, Ricardo Vasconcelos, Mónica Sousa, Lívia Palavra, Filipe |
dc.subject.por.fl_str_mv |
Child Magnetic Resonance Imaging Multiple Sclerosis Relapsing Criança Esclerose Múltipla Esclerose Múltipla Recidivante-Remitente Ressonância Magnética |
topic |
Child Magnetic Resonance Imaging Multiple Sclerosis Relapsing Criança Esclerose Múltipla Esclerose Múltipla Recidivante-Remitente Ressonância Magnética |
description |
Introduction: Pediatric-onset multiple sclerosis may contrast with adult-onset multiple sclerosis, in terms of disease activity. We aimed to determine differentiating features between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis, at diagnosis and after one year under disease modifying therapies, and analyse the attainment of the status of “No Evidence of Disease Activity” between groups.Material and Methods: We analyzed demographical, laboratory, clinical and imaging features of patients with relapsing-remitting multiple sclerosis diagnosed at our center, according to the McDonald’s 2010 criteria, with ≥ 1 year under disease modifying therapies and with available magnetic resonance imaging scans at diagnosis and one year after disease modifying therapies initiation. Patients were paired according to gender and disease modifying therapies in use. “No Evidence of Disease Activity” status was assessed, and differences were studied.Results: Fifteen pediatric-onset multiple sclerosis (aged ≥ 8 and < 18 years) and 15 adult-onset multiple sclerosis (≥ 18 and < 55 years) patients were recruited. We found a statistically significant difference in the number of T2 weighted image diffuse lesions/with poorly defined borders (p = 0.015). The mean expanded disability status scale score after one year under disease modifying therapies was lower in the pediatric-onset multiple sclerosis group (1.6 ± 0.8) compared to the adult-onset multiple sclerosis group (2.3 ± 0.8; p = 0.032). Nevertheless, no differences were found regarding the percentage of cases achieving “No Evidence of Disease Activity” in either group.Discussion: Although there is an empirical impression about the difference in inflammatory activity between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis, it was not possible to corroborate it in our study. Nevertheless, this was an exploratory and retrospective analysis of a small sample of patients, identifying variables in which such differences appear to be most important.Conclusion: Extensive studies of children, adolescents and adults with multiple sclerosis will be needed to categorize the clinical and radiological differences that allow the identification of drug response biomarkers in the early stages of the disease. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-04 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486 oai:ojs.www.actamedicaportuguesa.com:article/12486 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486 |
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eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/6196 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11598 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11599 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11610 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11611 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11612 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11613 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11614 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11664 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11665 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11666 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11667 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11668 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11669 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11670 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11671 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/11700 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12167 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12177 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12178 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12179 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12486/12419 |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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