Access to therapy for children and adolescents with multiple sclerosis: global considerations in preventing disease progression

IF 15.5 1区医学 Q1 PEDIATRICS

Lancet Child & Adolescent Health Pub Date : 2025-08-05 DOI:10.1016/S2352-4642(25)00133-6

Prof E Ann Yeh MD MA , Prof Helen Tremlett PhD , Rabporn Suntornlohanakul MD , Daniela Castillo-Villagran MD , Beyza Ciftci MD MSc , Prof Silvia Tenembaum MD , Andrea Savaransky MD , Prof Lekha Pandit MD , Prof Ming Lim MD PhD

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引用次数: 0

Abstract

Paediatric-onset multiple sclerosis comprises approximately 1·5% of prevalent multiple sclerosis cases and is associated with higher disease burden, early and progressive motor and cognitive disability in young adulthood, and high levels of depression and fatigue. Observational data and randomised controlled trials have shown marked effects of multiple sclerosis disease-modifying therapies on MRI activity and long-term outcomes, including disease progression, in the paediatric population. We present a comprehensive review of published literature focused on issues of access to therapy in children and adolescents with paediatric-onset multiple sclerosis. In this Review, we identify regional variability in availability of multiple sclerosis therapies and examine issues, such as differences in access to care and time to diagnosis, criteria for regulatory approval, availability of insurance, and government supports. Finally, we outline specific future directions that should be taken to address these barriers and ensure better and equal therapy access for all children and adolescents with multiple sclerosis.

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儿童和青少年多发性硬化症的治疗可及性：预防疾病进展的全球考虑

儿科发病的多发性硬化症约占流行多发性硬化症病例的1.5%，并与较高的疾病负担、成年早期和进行性运动和认知障碍以及高度抑郁和疲劳有关。观察性数据和随机对照试验表明，多发性硬化症疾病改善疗法对儿科人群的MRI活动和长期结局（包括疾病进展）有显著影响。我们对已发表的文献进行了全面的回顾，重点关注儿童和青少年儿童性多发性硬化症的治疗。在这篇综述中，我们确定了多发性硬化症治疗可获得性的地区差异，并研究了一些问题，如在获得护理和诊断时间、监管批准标准、保险可获得性和政府支持方面的差异。最后，我们概述了未来应该采取的具体方向，以解决这些障碍，并确保所有多发性硬化症儿童和青少年获得更好和平等的治疗机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Child & Adolescent Health Psychology-Developmental and Educational Psychology

CiteScore

40.90

自引率

0.80%

发文量

381

期刊介绍： The Lancet Child & Adolescent Health, an independent journal with a global perspective and strong clinical focus, presents influential original research, authoritative reviews, and insightful opinion pieces to promote the health of children from fetal development through young adulthood. This journal invite submissions that will directly impact clinical practice or child health across the disciplines of general paediatrics, adolescent medicine, or child development, and across all paediatric subspecialties including (but not limited to) allergy and immunology, cardiology, critical care, endocrinology, fetal and neonatal medicine, gastroenterology, haematology, hepatology and nutrition, infectious diseases, neurology, oncology, psychiatry, respiratory medicine, and surgery. Content includes articles, reviews, viewpoints, clinical pictures, comments, and correspondence, along with series and commissions aimed at driving positive change in clinical practice and health policy in child and adolescent health.