Clinical and Laboratory ObservationsInterferon-β treatment in patients with childhood-onset multiple sclerosis☆
Section snippets
Methods
All patients had clinically defined MS according to Poser's criteria.9 Data before treatment with IFN-β were recorded; 16 patients <18 years old were treated with IFN-β (1a: Avonex for 13, Rebif for 2; 1b: Betaferon for 1) subsequent to frequent or severe relapses. Patients fulfilled criteria for IFN-β treatment specified by French regulatory authorities, namely, being ambulatory with expanded Kurtzke disability status score (EDSS)10 <5.5 and having experienced a minimum of 2 attacks during the
Results
The group of patients included 14 girls and 2 boys. Two girls had an autoimmune disorder, either type 1 diabetes or thyroiditis, before treatment. In the month before the first attack, 2 patients had been vaccinated against hepatitis B. There was no familial antecedent of MS or other autoimmune diseases. Median age at the first attack was 13 years (range, 8.5-15.8 years). Only one boy developed MS before 10 years of age (8.5 years).
The initial clinical manifestations are reported in the Table.
Discussion
Few studies with immunomodulatory drugs have been performed in childhood MS. To date, there is no published report of treatment of childhood MS with recombinant IFN-β. In light of the well-documented efficacy of such treatment in adult MS, it was of considerable interest to evaluate its use in childhood MS. In our study, the high frequency of treatment failure (4/16, 25%) relative to that observed in any of the other trials5, 6, 7, 8 may be attributable to the selection of severe forms of
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