Clinical and Magnetic Resonance Imaging Outcomes in Pediatric-Onset MS Patients on Fingolimod and Ocrelizumab

Background Observational studies looking at clinical and MRI outcomes of treatments in pediatric MS, could assess current treatment algorithms, and provide insights for designing future clinical trials. Objective To describe baseline characteristics and clinical and MRI outcomes in MS patients initiating ocrelizumab and fingolimod under 18 years of age. Methods MS patients seen at 12 centers of US Network of Pediatric MS were included in this study if they had clinical and MRI follow-up and started treatment with either ocrelizumab or fingolimod prior to the age of 18. Results Eighty-seven patients initiating fingolimod and 52 initiating ocrelizumab met the inclusion criteria. Before starting fingolimod, mean annualized relapse rate was 0.43 (95% CI: 0.29 – 0.65) and 78% developed new T2 lesions while during treatment it was 0.12 (95% CI: 0.08 – 1.9) and 47% developed new T2 lesions. In the ocrelizumab group, the mean annualized relapse rate prior to initiation of treatment was 0.64 (95% CI: 0.38-1.09) and a total of 83% of patients developed new T2 lesions while during treatment it was 0.09 (95% CI: 0.04-0.21) and none developed new T2 lesions. Conclusion This study highlights the importance of evaluating current treatment methods and provides insights about the agents in the ongoing phase III trial comparing fingolimod and ocrelizumab.