Monitoring of treatment

IPMSSG guidelines

6-monthly MRI

Rebaseline MRI 6 months after initiation of a new therapy to avoid prematurely defining treatment failure

TREATMENT FAILURE relapses and MRI activity (new T2 lesions) in fully compliant patients and on full-dose treatment for a time that is sufficient for the drug to be considered effective

Treatment failure with injectable DMT, 25% to 64% across studies

Long term safety

Assessment for psychosocial and cognitive problems should be multidisciplinary task

Address the child's functioning at home, school, and among peers, andthe effect on the family

Ghezzi A, Amato MP, Makhani N, Shreiner T, Gartner J, Tenembaum S. Pediatric 27 multiple sclerosis: Conventional first-line treatment and general management. Neurology

; Duignan S, et al. Paediatric multiple sclerosis: a new era in diagnosis and treatment. Dev Med Child Neurol. 2019