Evidence map›Paper›PMID 39879675›Full record

ArticlePediatric neurology2025

Safety and Efficacy of Fingolimod and Ocrelizumab in Pediatric Patients With Multiple Sclerosis.

Benton Spirek, J Nicholas Brenton

Abstract read
In one paragraph

Article in Pediatric neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Ofatumumab in pediatric multiple sclerosis: a case series.Therapeutic advances in neurological disorders · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Benton SpirekUniversity of Virginia School of Medicine, Charlottesville, Virginia.
J Nicholas BrentonDivision of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, Virginia. Electronic address: jnb8h@uvahealth.org.

Funding

Obesity as a Driver of Inflammation and Brain Volume Loss in Pediatric Multiple SclerosisK23NS116225 · NINDS · UNIVERSITY OF VIRGINIA · PI BRENTON, JAMES NICHOLAS · 2021 to 2025
$962k
NINDS NIH HHS K23 NS116225
6 · The paper itself

Abstract

backgroundFingolimod and ocrelizumab are approved treatments for adults with multiple sclerosis (MS); however, only fingolimod is approved by the Food and Drug Administration for the treatment of pediatric MS. Currently, there are limited data for the safety and efficacy of ocrelizumab use in children.

methodsThis retrospective cohort study included patients with relapsing-remitting MS who started either ocrelizumab or fingolimod before age 18 years. Neuroimaging, electrocardiogram, laboratory evaluation, relapse history, and side effects were recorded at baseline and every six months.

resultsThirty-six pediatric patients were included (fingolimod, n = 14; ocrelizumab, n = 22). Clinical relapses occurred in 14% of patients treated with fingolimod versus in none of the patients treated with ocrelizumab. Seventy-one percent of patients in the fingolimod group switched or discontinued therapy compared with 9% treated with ocrelizumab (P = 0.0001). From patients with greater than six months of treatment on the given therapy (fingolimod n = 10, ocrelizumab n = 17), 60% on fingolimod exhibited new/enlarged T2-hyperintense lesions on brain magnetic resonance imaging compared with 6% on ocrelizumab (P = 0.004). Of those treated with ocrelizumab, 10 of 22 (45%) had infusion reactions during their initial infusion. Reaction rates decreased to 20% with subsequent infusions.

conclusionsOcrelizumab is associated with fewer brain lesions, lower clinical relapse rates, and reduced discontinuation rates compared with fingolimod. Although both therapies have the potential for adverse effects, these are unlikely to prompt discontinuation of therapy in isolation. These findings highlight the benefits of ocrelizumab as a treatment option for children and youth living with MS.

Indexed as

Antibodies, Monoclonal, HumanizedFingolimod HydrochlorideImmunologic FactorsImmunosuppressive AgentsMultiple Sclerosis, Relapsing-RemittingAdolescentChildFemaleHumansMaleRetrospective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedFingolimod HydrochlorideImmunologic FactorsImmunosuppressive AgentsocrelizumabChildrenDisease-modifying therapyImmunoglobulinsMRIMultiple sclerosisRelapseTreatment

Identifiers

PMID39879675
PMCPMC11846694

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.