New findings suggest obesity is linked to multiple sclerosis risk and response to first-line therapy in a pediatric population in Germany. Researchers found obesity appeared to be linked to increased risk of pediatric MS and with worse treatment response to first-line treatment. The study’s authors said a healthy weight may potentially optimize treatment outcomes and reduce the disease burden and costs.

Obesity reportedly increases the risk of pediatric MS, but little is known about its association with disease course. Researchers at the University Medical Center Göttingen, Georg August University Göttingen, Göttingen, Germany, set out to investigate the association of obesity with pediatric MS risk and with first-line therapy response among children with MS.

This single-center retrospective study used the medical records and database at the Center for MS in Childhood and Adolescence, Göttingen, Germany. The study included 453 patients with relapsing-remitting pediatric MS and body mass index measurement taken within six months of diagnosis. Onset of the disease occurred between April 28, 1990, and June 26, 2016, and the mean disease duration was 38.4 months. Data were collected from July 14, 2016, to Dec. 18, 2017.

In total, 453 patients with pediatric MS were included, of whom 306 (67.5 percent) were female, and the mean age at diagnosis was 13.7 years. At diagnosis, 126 patients (27.8 percent) were overweight or obese, with obesity associated with twofold odds of MS in both sexes. Obese patients, compared with non-overweight patients, had more relapses on first-line treatment with interferon beta and glatiramer acetate and a higher rate of second-line treatment. Baseline neuroimaging, interval between first and second MS attacks, pretreatment relapses, and Expanded Disability Status Scale progression scores were not correlated with BMI.

In this study, increased pediatric MS risk appeared to be associated with obesity, and obese patients did not respond well to first-line medications. Altered pharmacokinetics appeared to be most likely factors in treatment response, suggesting that achieving healthy weight or adjusting the dose according to BMI could improve therapy response.

The results were published in JAMA Neurology.