Progress for Patients With Pediatric MS, Fingolimod's Risk-Benefit Profile: Brenda Banwell, MD

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“Given that pediatric MS is a highly inflammatory disease, with high relapse rates and a lot of T2 lesion burden, the imperative to get these highly effective therapies to our patients is extremely high and urgent.”

At the 2022 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, from October 26-28, in Amsterdam, Netherlands, Brenda Banwell, MD, gave the welcome lecture on the first day of the meeting, offering an overview of the progress that's been made in the clinical care of patients with pediatric-onset multiple sclerosis (POMS). She spoke at length about the momentum the field has gained in this area and the need to continue to better understand the unique facets and similarities between adult and pediatric disease.

Banwell also gave an oral presentation on fingolimod’s superior efficacy on relapses and MRI outcomes over interferon (IFN) beta-1a in POMS from the core phase (CP) of PARADIGMS trial (NCT01892722), which was was a double-blind, active-controlled, randomized trial of patients with PedMS that included 215 individuals treated up to 2 years followed by a 5-year, open-label expansion phase (EP) (n = 171). The dosage of fingolimod was at 0.5 mg/d or 0.25 mg/d according to the patients’ body weight (patients more than 40 kg received 0.5 mg/d dose).

Adjusted annualized relapse rate (ARR) was 0.11 (95% CI, 0.08, 0.16) for the continuous fingolimod group in CP+EP and 0.34 (95% CI, 0.25, 0.47) in the switch group. The most frequently reported adverse events (more than 20%) were nasopharyngitis (43.5%), headache (34.1%), leukopenia (25.3%), and upper respiratory tract infection (21.2%).

In a recent interview with NeurologyLive^®, Banwell, chief of neurology, codirector of the neuroscience Center, The Children's Hospital of Philadelphia, professor of neurology and Pediatrics, the University of Pennsylvania, discussed her presentation from ECTRIMS 2022. Additionally, she gave an overview of the takeaway points on POMS from a clinician's perspective.

REFERENCES
1. Deiva K, Banwell B, Gärtner J. Long-term efficacy and safety of fingolimod in paediatric multiple sclerosis patients: analysis of PARADIGMS study up to 6 years of treatment. Presented at: 2022 ECTRIMS Congress; October 26-28; Amsterdam, Netherlands. Oral Presentation 69