Current international trends in the treatment of multiple sclerosis in children: impact of the COVID-19 pandemic

Fredrik Sandesjö, Evangeline Wassmer, Kumaran Deiva, Maria Pia Amato, Tanuja Chitnis, Cheryl Hemingway, Lauren Krupp, Daniela Pohl, Kevin Rostasy, Emanuelle Waubant, Brenda Banwell, Ronny Wickström*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Only recently has the first disease-modifying therapy been approved for children with multiple sclerosis (MS) and practice patterns including substantial off-label use have evolved. Understanding attitudes towards treatment of paediatric MS and whether this has changed due to the ongoing COVID-19 pandemic is vital to guide future therapeutic trials and for developing guidelines that reflect practice.

Methods: We performed an online survey within the International Paediatric Multiple Sclerosis Study Group between July and September 2020. The survey was sent to 130 members from 25 countries and consisted of five sections: demographic data, treatment, disease modifying therapies and COVID-19, outcome and three patient cases.

Results: The survey was completed by 66 members (51%), both paediatric neurologists and adult neurologists. Fingolimod and β-interferons were the most frequently used disease-modifying therapies, especially among paediatric neurologists. Almost a third (31%) of respondents had altered their prescribing practice due to COVID-19, in particular at the beginning of the pandemic.

Conclusions: The survey results indicate a tendency of moving from the traditional escalation therapy starting with injectables towards an early start with newer, highly effective disease modifying therapies. The COVID-19 pandemic only slightly affected prescribing patterns and treatment choices in paediatric MS.
Original languageEnglish
Article number103277
JournalMultiple Sclerosis and Related Disorders
Early online date27 Sept 2021
Publication statusPublished - Nov 2021

Bibliographical note

© 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license

Funding: Financial support without any role in the design and conduct of this study was obtained from Stockholm City Council, Stiftelsen Barnforskningen vid Astrid Lindgrens Barnsjukhus and Sällskapet Barnavård.


  • COVID-19
  • MS
  • pediatric disease
  • modifying therapy


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