Advancing Multiple Sclerosis Care for Kids

With about 10% of multiple sclerosis (MS) patients having their first symptoms before the age of 18, it's critical to get the right diagnosis, and treatment, early to improve long-term outcomes for kids. That's why advancing research into MS care is so important.

"My passion for research comes from my interactions with these patients," says J. Nicholas Brenton, MD, a pediatric neurologist and pediatric MS researcher at UVA Health. "The majority of treatments in multiple sclerosis have been studied in adults, and there have been few studies in pediatric patients."

At UVA Health Children's, we're trying to change that. Our Multiple Sclerosis Center is recognized by the National Multiple Sclerosis Society as a Center for Comprehensive Multiple Sclerosis Care and is a recognized member of the Consortium of Multiple Sclerosis Centers. That's in part thanks to the tireless work of researchers like Brenton.

Here, Brenton answers questions about pediatric MS research at UVA Health.

How does UVA Health Children’s help pediatric MS patients manage their transition into adulthood? If they elect to travel out of the state for college, are we able to help them with continuance of care through class time as well as during breaks?

We work very closely with our patients as they begin the transition into adulthood. I personally follow most of our patients through their college years, since this can be a tricky time to transition to a new neurologist.

As our patients get older, and once they figure out where their future lies, we work one-on-one with them to identify an adult neuroimmunologist within their area. We work to “sandwich” appointments with their new provider and me so that they are not lost to follow-up and so that we fully ensure they are firmly established with their new provider.

It's our hope that we're always viewed as a steadfast keystone for our patients as they move through this (potentially) vulnerable time.

In the 1990s, adult-onset MS had few treatment options. Now there are dozens of approved medicines. Do you think we’ll see more of these medicines used for pediatric patients? Or will new treatments need to be researched and discovered?

Yes, in fact, many of these adult-approved medications are now being actively studied in pediatric patients through various clinical trials, many of which have recently completed or are ongoing.

We've already garnered approval for one of these therapies (fingolimod), and I expect we'll continue to see approval of newer therapies for children as the safety and efficacy of these drugs are determined within this unique population.

What recent MS clinical trials has UVA Health Children's been involved in?

The one we just finished is now closed. The trial was Operetta 2 - NCT05123703. The focus of the trial was to study the safety and efficacy of an every-6-months, infusion-based therapy (ocrelizumab) in pediatric-onset MS.

To be fully clear, we are using this medication off-label actively now in kids, but the hope is that this trial will garner a Food and Drug Administration (FDA) approval for children. This drug is very efficacious in the adult MS population, and the every-6-months treatment timeline makes it much more feasible for patients/families. 

When should a patient's family consider enrolling them in a MS clinical trial?

A patient should consider enrolling in a clinical trial for pediatric MS if the goals of the study align somewhat with their treatment goals. A secondary reason is often to help provide a better knowledge of the safety and efficacy of the newer disease-modifying therapies in the pediatric population.

How can patients get access to these clinical trials?

Typically, access to clinical trials is through clinical practices that have expertise in treating pediatric MS and offer clinical trial opportunities. Our site’s clinical trial team reviews each individual patient based on their level of interest, eligibility, and overall fit for the available trials.