Fingolimod Prescribed for the Treatment of Multiple Sclerosis in Patients Younger Than Age 18 Years

• Published in: Pediatric neurology 2015-08, Vol.53 (2), p.166-168
• Main Authors: Fragoso, Yara Dadalti, MD, MSc, PhD, Alves-Leon, Soniza Vieira, MD, PhD, Barreira, Amilton Antunes, MD, PhD, Callegaro, Dagoberto, MD, MSc, PhD, Brito Ferreira, Maria Lucia, MD, Finkelsztejn, Alessandro, MD, MSc, PhD, Gomes, Sidney, MD, PhD, Magno Goncalves, Marcus Vinicius, MD, Moraes Machado, Maria Iris, MD, Marques, Vanessa Daccach, MD, MSc, Cunha Matta, Andre Palma, MD, PhD, Papais-Alvarenga, Regina Maria, MD, MSc, PhD, Apostolos Pereira, Samira Luisa, MD, PhD, Tauil, Carlos Bernardo, MD, MSc
• Format: Article
• Language: English
• Subjects: Adolescent; adolescents; Brazil; Child; Child, Preschool; children; Disability Evaluation; Drug Prescriptions; Female; fingolimod; Fingolimod Hydrochloride - therapeutic use; Follow-Up Studies; Humans; Immunosuppressive Agents - therapeutic use; Magnetic Resonance Imaging; Male; multiple sclerosis; Multiple Sclerosis - drug therapy; Neurology; Pediatrics
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2015.03.024

Abstract Background There have been no clinical trials for approval of medications for treating multiple sclerosis in patients younger than age 18 years. All treatments are based on personal experience and data from open observational studies. Fingolimod is an oral drug for multiple sclerosis that has been shown to be efficient and safe in adults. The aim of our study is to describe patients with multiple sclerosis who started treatment with fingolimod before the age of 18 years. Participants and methods Seventeen patients treated with fingolimod were identified in the Brazilian database of children and adolescents with multiple sclerosis. The average time of use of the drug was 8.6 months. Results Fingolimod showed a good safety and efficacy profile in these patients, all of whom had very active multiple sclerosis. After starting treatment with fingolimod, only one patient had a relapse and a new lesion on magnetic resonance imaging. The patients' degree of disability did not progress. No major adverse events were reported in relation to the first dose of the drug, nor in the short- and medium-term treatment. No patient has been followed for longer than 18 months, thus limiting long-term conclusions. Conclusions Off-label use of fingolimod in patients younger than age 18 years may be a good therapeutic option for multiple sclerosis control.