Off-label Use of DMTs for Pediatric MS
- dimethyl fumarate (Tecfidera)
- teriflunomide (Aubagio)
- alemtuzumab (Lemtrada)
- natalizumab (Tysabri)
- rituximab (Rituxan)
- glatiramer acetate (Copaxone)
- interferon beta (Avonex, Rebif, Plegridy)
Options for Treating MS Relapses
Although most children generally tolerate corticosteroids well, they may experience some side effects, such as:
- Behavior changes
- Increases in blood sugar levels
- Nausea
Other options for treating relapse include plasma exchange and intravenous immunoglobulin (IVIG). Plasma exchange, also called plasmapheresis or PLEX, essentially removes the antibodies in the blood that attack myelin in the nerve cells of people with MS. Several treatments are given over a couple of weeks.
Additional Parts of the MS Treatment Plan
Any treatment plan for children with MS should also include:
- Physical therapy
- Occupational therapy
- Speech therapy
These can help improve mobility, muscle strength, and balance and coordination.
It’s important to remember that children diagnosed with MS can experience emotional and social challenges. Having a chronic condition like MS can affect a young person’s self-confidence, academic performance, peer relationships, family and social life, and overall behavior.
It may also impact how they view their lives, both in the present and in the future.
Thus, Krupp says, it’s vital that children with MS communicate regularly with school counselors, therapists, and others who can help them with these challenges. Encourage them to talk about their experiences and problems, and make sure they get support from teachers, family, friends, and other members of the community.
“A team that provides counseling, ideally peer-based support programs, is key,” she says.
Yeh adds that a comprehensive program should address all the needs of children with MS, and ideally should include physicians, nurses, nurse practitioners, social workers, psychologists, neuropsychological assessment, and physiotherapists and occupational therapists, among other healthcare workers.
Ultimately, planning your child’s MS treatment should include discussing the goals and expectations of the child and the family, as well as any potential risks. Children on DMTs and other prescription medication should also undergo routine monitoring (including blood tests, MRIs, and other tests) to make sure the treatment is working and to minimize side effects.
Read the full article here
