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Review
. 2019 Nov;61(11):1281-1288.
doi: 10.1111/dmcn.14228. Epub 2019 Apr 16.

Treatment in childhood central nervous system demyelinating disorders

Bahadir Konuskan  1 , Banu Anlar  1
Affiliations
Review

Treatment in childhood central nervous system demyelinating disorders

Bahadir Konuskan et al. Dev Med Child Neurol. 2019 Nov.

Abstract
in English, Spanish, Portuguese

The last two decades witnessed significant advances in the treatment of acquired demyelinating disorders: thirteen new agents have been approved for the treatment of multiple sclerosis in adults by the European Medicines Agency and US Food and Drug Administration in the last twenty years. Although the long-term efficacy and safety profiles of some new drugs are still being assessed in paediatric MS, clinicians may have to use them in the management of paediatric onset MS resistant to first-line medications, based on results obtained in adult-onset disease. This review summarizes the current approach to treatment in children with demyelinating syndromes. WHAT THIS PAPER ADDS: Serological markers affect management in paediatric demyelinating diseases. Antibodies against aquaporin-4 and myelin oligodendrocyte glycoprotein should be tested in children with acute demyelinating disease. New therapeutic agents currently in trial for pediatric disease should be used with close follow-up.

TRATAMIENTO EN LOS TRASTORNOS DESMIELINIZANTES DEL SISTEMA NERVIOSO CENTRAL INFANTIL: Las últimas dos décadas fueron testigos de avances significativos en el tratamiento de los trastornos desmielinizantes adquiridos, como lo demuestra la aprobación de 13 nuevos agentes por parte de la Agencia Europea de Medicamentos y la Administración de Medicamentos y Alimentos de los EE. UU. para el tratamiento de la esclerosis múltiple en adultos. A pesar de ciertas preguntas sobre los perfiles de eficacia y seguridad de los nuevos tratamientos en niños, la expansión de las opciones terapéuticas proporciona flexibilidad en la toma de decisiones basada en la potencia, los riesgos y las preferencias del paciente. En los casos pediátricos resistentes a los medicamentos estándar, los médicos frecuentemente guían su manejo basándose en los resultados obtenidos en la enfermedad de aparición en la edad adulta. Esta revisión resume el enfoque actual del tratamiento en niños con síndromes desmielinizantes.

TRATAMENTO EM DESORDENS DESMIELINIZANTES DO SISTEMA NERVOSO CENTRAL NA INFÂNCIA: As últimas duas décadas testemunharam avanços significativos no tratamento de desordens desmielinizantes adquiridas: 13 novos agentes foram aprovados pela Agência Européia de Medicamentos e a Administração de Alimentos e Medicamentos dos EUA para o tratamento da esclerose múltipla em adultos. Apesar de a eficácia em longo prazo e segurança de novos tratamentos ainda estejam sendo avaliados em EM pediátrica, clínicos podem ter que utilizá-las no manejo de EM de início pediátrico resistente a medicamentos de primeira linha, com base em resultados obtidos em casos de doença de início na vida adulta. Esta revisão sintetiza a abordagem atual para o tratamento de crianças com síndromes desmielinizantes.

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References

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