Abstract
Many pediatric patients diagnosed with multiple sclerosis experience breakthrough disease despite appropriate therapy. Although many options are available to reduce disease activity, none are considered fully effective, and therapies are switched when disease control is suboptimal. However, there are no universally accepted criteria for treatment failure. Two clinical cases are presented that illustrate failure of disease control despite first-line treatment. This chapter explores the clinical and radiological criteria employed to help define disease activity and the approaches toward treatment, including timing of switching therapy, alternating between first-line therapies, and advancing to more aggressive therapies. A brief review of currently available drugs used for pediatric MS with inadequate clinical response is also included.
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Orlova, Y.Y., Thompson-Stone, R.I., Bhise, V.V. (2017). Breakthrough Disease in Pediatric MS. In: Waubant, E., Lotze, T. (eds) Pediatric Demyelinating Diseases of the Central Nervous System and Their Mimics. Springer, Cham. https://doi.org/10.1007/978-3-319-61407-6_5
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DOI: https://doi.org/10.1007/978-3-319-61407-6_5
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