New research reveals that initiating monoclonal antibody therapy during childhood, rather than delaying treatment until early adulthood, significantly reduces long-term disability in multiple sclerosis patients.

Utilizing data from the French MS Registry, Italian MS Register, and the global MSBase Registry, researchers at the University of Melbourne, in Australia, analyzed the outcomes of 282 patients with pediatric-onset MS who began experiencing symptoms before the age of 18. Patients were divided into two groups based on when they initiated monoclonal antibody treatment: either between the ages of 12-17 or 20-22 years.

Using the Expanded Disability Status Scale to measure and monitor disability progression in MS, the study showed that patients who began treatment between the ages of 12-17 years had a mean absolute increase of only 0.4 points on the EDSS, compared to a 0.95-point increase in those who started treatment later.

Between the ages of 23 and 27, the increase in EDSS scores from baseline was 0.57 points lower in the early treatment group compared to the late treatment group. The benefits of early treatment persisted throughout the median follow-up period of 10.8 years. Researchers said the substantially lower risk of progressing to higher disability levels in the early treatment group was particularly evident in the moderate disability range, where further progression was reduced by up to 97 percent.

Because of limited evidence of the efficacy, safety, and effects of monoclonal antibodies on children's development, regulatory restrictions often delay access to these treatments for pediatric-onset MS patients until adulthood. The study’s authors argue their findings are a strong argument for rethinking current treatment guidelines. By allowing earlier access to effective treatments, the quality of life for children with MS can be significantly enhanced and the burden of long-term disability reduced.

The research team is dedicated to generating further evidence to support the treatment of pediatric-onset MS, with a particular focus on assessing the long-term risks of immunosuppressive therapies in this population.

The findings were presented at ECTRIMS 2024.