{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:25:36Z","timestamp":1787397936852,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Swedish Brain Fund"},{"DOI":"10.13039\/501100020325","name":"S\u00e4llskapet Barnav\u00e5rd","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007436","name":"erling-perssons stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007436","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001862","name":"svenska forskningsr\u00e5det formas","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001862","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bjarne Ahlstr\u00f6m\u2019s Memorial Fund"},{"name":"Region Stockholm"},{"name":"Kronprinsessan Lovisas f\u00f6rening f\u00f6r barnasjukv\u00e5rd och Stiftelsen Axel Tielmans Minnesfond"},{"DOI":"10.13039\/501100008352","name":"Stiftelsen Samariten","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Comparative studies in paediatric-onset multiple sclerosis (PoMS) that also include highly effective monoclonal antibody therapies are rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare treatment persistence, as a proxy of effectiveness and tolerability, across disease-modifying therapies (DMTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Nationwide cohort study using Swedish MS Registry data on individuals with MS onset before age 18 from 2000 to 2024. Treatment persistence was analysed using Kaplan\u2013Meier and Cox models, adjusted for demographics and treatment epoch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 383 individuals (69.2% female; median onset age 15.8 and 17.2\u2009years at first DMT start), observed for a median 10.1\u2009years (interquartile range (IQR): 5.5\u201315.5), yielding 934 treatment episodes: rituximab (272), injectables (263), natalizumab (248), fingolimod (86) and dimethyl fumarate (65). Median age at any treatment initiation, regardless of treatment sequence, was 18.9\u2009years, with a median Expanded Disability Status Scale (EDSS) score of 1.5 (IQR: 0.0\u20132.0). Treatment persistence never dropped below 50% for rituximab, while median persistence was 35.6\u2009months for natalizumab (95% confidence interval (CI): 28.8\u201344.9), 34.7 for dimethyl fumarate (95% CI: 21.7\u201356.9), 32.0 for fingolimod (95% CI: 21.1\u201348.1) and 17.6 for injectables (95% CI: 14.4\u201320.8). Compared to injectables, adjusted hazard ratios (HRs) for discontinuation were significantly lower for rituximab (0.09; 95% CI: 0.07\u20130.12), natalizumab (0.39; 95% CI: 0.31\u20130.48), fingolimod (0.41; 95% CI: 0.30\u20130.55) and dimethyl fumarate (0.49; 95% CI: 0.36\u20130.68).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Rituximab displayed the highest treatment persistence, supporting B-cell depletion as a first-line option in PoMS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261448789","type":"journal-article","created":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T07:53:02Z","timestamp":1780213982000},"page":"829-838","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment persistence in paediatric-onset multiple sclerosis: A Swedish nationwide registry study"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5196-6839","authenticated-orcid":false,"given":"Fredrik","family":"Sandesj\u00f6","sequence":"first","affiliation":[{"name":"Neuropediatric Unit, Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9081-1522","authenticated-orcid":false,"given":"Kyla A","family":"McKay","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0030-0236","authenticated-orcid":false,"given":"Katharina","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8329-5219","authenticated-orcid":false,"given":"Fredrik","family":"Piehl","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1183-150X","authenticated-orcid":false,"given":"Ronny","family":"Wickstr\u00f6m","sequence":"additional","affiliation":[{"name":"Neuropediatric Unit, Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurot.2025.e00631"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25737"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000001008"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208114"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103277"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2025.2481868"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/pn-2024-004228"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16289"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2010.04.001"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102507"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756286419837809"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-019-00160-9"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.4011"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.27012"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16253"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00209-5"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12963"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16228"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-025-01276-z"},{"issue":"1","key":"e_1_3_3_21_2","article-title":"Validation of the Swedish multiple sclerosis registry for pediatric-onset multiple sclerosis","volume":"11","author":"Sandesj\u00f6 F","year":"2025","unstructured":"Sandesj\u00f6 F, Alping P, Fink K, et al. Validation of the Swedish multiple sclerosis registry for pediatric-onset multiple sclerosis. Mult Scler J Exp Transl Clin 2025; 11(1): 20552173251314118.","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/children12030259"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.5566"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12610-y"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25119"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2023.04.020"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706383"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-024-02011-w"},{"key":"e_1_3_3_29_2","unstructured":"WHO endorses landmark public health decisions on Essential Medicines for Multiple Sclerosis https:\/\/www.who.int\/news\/item\/26-07-2023-who-endorses-landmark-public-health-decisions-on-essential-medicines-for-multiple-sclerosis (accessed 16 June 2025)."},{"key":"e_1_3_3_30_2","unstructured":"Clinical Trials. A phase III multicenter randomized double-blind double-dummy study to evaluate safety and efficacy of ocrelizumab in comparison with fingolimod in children and adolescents with relapsing-remitting multiple sclerosis. Clinical Trial Registration NCT05123703 https:\/\/clinicaltrials.gov\/study\/NCT05123703 (2025 accessed 28 May 2025)."},{"key":"e_1_3_3_31_2","unstructured":"Clinical Trials. A 2-year randomized 3-arm double-blind non-inferiority study comparing the efficacy and safety of ofatumumab and siponimod versus fingolimod in pediatric patients with multiple sclerosis followed by an open-label extension. Clinical Trial Registration NCT04926818 https:\/\/clinicaltrials.gov\/study\/NCT04926818 (2025 accessed 8 October 2025)."},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458516653667"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.188"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.6345"},{"key":"e_1_3_3_35_2","unstructured":"Svenska MS-s\u00e4llskapet. 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