A study published in JAMA Neurology found that children with Multiple Sclerosis (MS) are less likely to experience progression independent of relapse activity (PIRA) or relapse-associated worsening over a decade of follow-up compared to individuals with adult- or late-onset MS. However, PIRA increases rapidly in this patient population beginning in young adulthood. The study included 16,130 MS patients, with 1383 diagnosed with pediatric-onset MS and 14,113 diagnosed with adult-onset MS. The study found that pediatric-onset MS patients had less disability based on Expanded Disability Status Scale (EDSS) scores, more active disease, and longer exposure to Disease Modifying Therapy (DMT), and were less likely to experience PIRA compared to the other subgroups. The study reinforced the benefit of DMT initiation in pediatric onset MS patients, as it was associated with reduced occurrence of both PIRA and relapse-associated worsening regardless of the age at onset. Some study limitations included using EDSS as the sole measure of confirmed disability accrual events and potential underestimation of events indicating PIRA.
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PIRA in Children With MS: Early Disease-Modifying Therapy May Offer Protection
