Evidence map›Paper›PMID 41195640›Full record

ArticleAnnals of neurology2026

Real-World Effectiveness of Switching to Oral or Infusion Versus Injectable Disease-Modifying Therapy in Pediatric Multiple Sclerosis.

Aaron W Abrams, Michael Waltz, T Charles Casper, Gregory Aaen, Leslie A Benson, Eva-Chava M Bernfeld, Leigh E Charvet, Tanuja Chitnis, Carla Francisco, Mark P Gorman and 18 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

28 authors.

Aaron W AbramsDepartment of Neurology, Cleveland Clinic, Cleveland, OH.ORCID 0000-0002-4607-5740
Michael WaltzDepartment of Pediatrics, University of Utah, Salt Lake City, UT.
T Charles CasperDepartment of Pediatrics, University of Utah, Salt Lake City, UT.
Gregory AaenDepartment of Pediatrics, Loma Linda University, San Bernardino, CA.
Leslie A BensonDepartment of Neurology, Boston Children's Hospital, Boston, MA.
Eva-Chava M BernfeldDepartment of Neurology, Cleveland Clinic, Cleveland, OH.
Leigh E CharvetDepartment of Neurology, New York University Langone Health, New York, NY.ORCID 0000-0003-4429-9713
Tanuja ChitnisDepartment of Pediatric Neurology, Massachusetts General Hospital, Boston, MA.
Carla FranciscoDepartment of Neurology, University of California, San Francisco, CA.
Mark P GormanDepartment of Neurology, Boston Children's Hospital, Boston, MA.
Jennifer S GravesDepartment of Neurology, University of California, San Diego, La Jolla, CA.
Lauren KruppDepartment of Neurology, New York University Langone Health, New York, NY.ORCID 0000-0001-7003-807X
Kimberly O'NeillDepartment of Neurology, New York University Langone Health, New York, NY.ORCID 0000-0001-6021-8683
Timothy E LotzeDepartment of Neurology, Texas Children's Hospital, Houston, TX.
Soe MarDepartment of Neurology, Washington University in Saint Louis, St Louis, MO.
Jayne NessDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
Mary RenselDepartment of Neurology, Cleveland Clinic, Cleveland, OH.
Moses RodriguezDepartment of Neurology, Mayo Clinic, Rochester, MN.
John RoseDepartment of Neurology, University of Utah, Salt Lake City, UT.
Alice RutatangwaDepartment of Neurology, University of California, San Francisco, CA.
Teri SchreinerDepartment of Neurology and Pediatrics, University of Colorado, Aurora, CO.
Nikita ShuklaDepartment of Pediatrics and Neurology, Dell Children's Hospital, University of Texas, Austin, TX.
Jan-Mendelt TillemaDepartment of Neurology, Mayo Clinic, Rochester, MN.
Bianca Weinstock-GuttmanDepartment of Neurology, State University of New York at Buffalo, Buffalo, NY.
Yolanda WheelerDepartment of Nursing, University of Alabama at Birmingham, Birmingham, AL.
Emmanuelle WaubantDepartment of Neurology, University of California, San Francisco, CA.ORCID 0000-0001-5188-0157
Kristen M KryskoDivision of Neurology, Department of Medicine, BARLO MS Centre, St. Michael's Hospital, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Canada.ORCID 0000-0003-0090-597X
US Network of Pediatric MS Centers

Funding

National Multiple Sclerosis Society HC-1509-06233
6 · The paper itself

Abstract

objectiveTo assess real-world effectiveness of switching disease-modifying therapy (DMT) in pediatric multiple sclerosis (MS) and clinically isolated syndrome (CIS) initially treated with platform injectables on disease activity.

methodsOf 2615 pediatric-onset demyelinating disease patients at 12 clinics in the United States (US) Network of Pediatric MS Centers, those with MS/CIS on initial therapy with a platform injectable who switched to another class of platform injectable, oral or infusion DMT were analyzed. Relapse rate was modeled with negative binomial regression, adjusted for preidentified confounders.

resultsA total of 212 children switched DMT before age 18 (67% female, 95% MS). Ninety-three switched from injectable to injectable, 76 injectable to oral, and 43 injectable to infusion. Switchers to oral or infusion were older at onset (injectable 12.3 years, oral 13.5 years, and infusion 14.2 years) and switch (injectable 14.6 years, oral 16.0 years, and infusion 15.7 years). Switchers to infusion DMT were more likely to have enhancing lesions (injectable 45%, oral 28%, and infusion 67%). Compared to injectable (annualized relapse rate [ARR] = 0.88, 95% confidence interval [CI] = 0.52-1.48), relapse rates were lower for injectable to oral (ARR = 0.34, 95% CI = 0.20-0.57; rate ratio: 0.38, 95% CI = 0.21-0.69) and injectable to infusion (ARR = 0.18, 95% CI = 0.09-0.37; rate ratio: 0.21, 95% CI = 0.10-0.44) (p < 0.001). Adjusted number needed to treat in person-years to prevent 1 relapse with oral over injectable was 1.84 (95% CI = 1.03-8.69) and infusion over injectable 1.43 (95% CI = 1.00-3.88).

interpretationSwitching from platform injectable to oral or infusion compared to other platform injectable DMT led to better disease control in pediatric MS. Long-term safety data are required. ANN NEUROL 2026;99:715-729.

Indexed as

Immunologic FactorsMultiple SclerosisAdministration, OralAdolescentChildFemaleHumansInfusions, IntravenousInjectionsMaleTreatment OutcomeImmunologic Factors

Identifiers

PMID41195640
PMCPMC12954145

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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.