neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2023-4-1-43-51yjkpuyneurojour-87Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSЛечение рассеянного склероза у детей: обзор клинических исследованийTreatment of multiple sclerosis in children: review of clinical trialshttps://orcid.org/0000-0003-1574-2050АбдуллаеваЛуизат МуслимовнаAbdullaevaLuizat M.

Младший научный сотрудник лаборатории редких наследственных болезней у детей Медико-генетического центра, врач-невролог центра детской психоневрологии ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России, 119991, Москва, Россия.

e-mail: instorm@inbox.ru 

MD, junior research assistant of the Laboratory of rare hereditary diseases in children of the medical genetic center, neurologist of the Center of child psychoneurology, National Medical Research Center of Children’s Health, Moscow, 119991, Russian Federation.

e-mail: instorm@inbox.ru 

instorm@inbox.ruhttps://orcid.org/0000-0001-8506-2064БурсаговаБелла И.BursagovaBella I.noemail@neicon.ruhttps://orcid.org/0000-0002-7269-9100КуренковАлексей Л.KurenkovAlexey L.noemail@neicon.ruhttps://orcid.org/0000-0002-9562-3774КузенковаЛюдмила М.KuzenkovaLyudmila M.noemail@neicon.ruФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииРоссияNational Medical Research Center for Children’s HealthRussian FederationФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияNational Medical Research Center for Children’s Health; I.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202312052023414351Copyright © Абдуллаева Л.М., Бурсагова Б.И., Куренков А.Л., Кузенкова Л.М., 20232023Абдуллаева Л.М., Бурсагова Б.И., Куренков А.Л., Кузенкова Л.М.Abdullaeva L.M., Bursagova B.I., Kurenkov A.L., Kuzenkova L.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/87

Рассеянный склероз (РС) является редким нейровоспалительным и нейродегенеративным заболеванием, приводящим к инвалидизации и значительному снижению качества жизни. За последнее десятилетие исследования препаратов, изменяющих течение РС (ПИТРС), у взрослых значительно расширились в пользу применения высокоэффективных препаратов на ранних стадиях заболевания, а у педиатрических пациентов отдают предпочтение более безопасным, но менее эффективным ПИТРС.

Сегодня только два ПИТРС (финголимод и терифлуномид) были изучены в крупных исследованиях фазы III и одобрены регулирующими органами для использования у детей.

В последние годы всё большее число детей с РС получают высокоэффективную терапию такими препаратами, как натализумаб, моноклональные антитела к CD20, моноклональные антитела к CD52, а также аутологичную трансплантацию гемопоэтических стволовых клеток. Эти высокоэффективные методы лечения обеспечивают выраженное снижение воспалительной активности заболевания по сравнению с ПИТРС первой линии. Поэтому в настоящее время проводятся исследования фаз II и III, изучающие их эффективность и безопасность у детей с РС.

Данный описательный обзор посвящён базисному лечению РС у педиатрических пациентов, изучению характеристик эффективности и безопасности доступного в настоящее время арсенала лекарственных средств.

Участие авторов

Участие авторов:Абдуллаева Л.М. — концепция и дизайн, написание текста, редактирование;Бурсагова Б.И. — написание текста, редактирование;Куренков А.Л. — редактирование;Кузенкова Л.М. — редактирование.Все авторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 17

Поступила 17.02.2023Принята к печати 03.03.2023Опубликована 20.04.2023

Multiple sclerosis (MS) is a rare neuroinflammatory and neurodegenerative disease that leads to disability and a significant decrease in the quality of life. Over the past decade, the focus of studies of MS disease-modifying therapies (DMT) in adults have significantly changed to highly effective drugs at the early stages of the disease; in pediatric patients, safer, but less effective DMTs are preferred.

Today, only two DMTs (fingolimod and teriflunomide) investigated over large phase III studies were approved by regulatory authorities for use in children.

In recent years, an increasing number of MS children have been receiving highly effective therapy with drugs such as natalizumab, monoclonal antibodies to CD20, monoclonal antibodies to CD52, and autologous hematopoietic stem cell transplantation. These highly effective methods of treatment provide a significant reduction in the inflammatory activity of the disease compared to the first-line DMTs. Therefore, a number of phase II and III studies are currently conducted to assess their efficacy and safety in MS children.

This review is related to the basic treatment of MS in pediatric patients, the study of the efficacy and safety of the currently available drugs.

Contribution

Contribution:Abdullaeva L.M. — concept and design of the study, writing the text, editing;Bursagova B.I. — writing the text, editing;Kurenkov A.L. — editing;Kuzenkova L.M. — editing;All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgements

Acknowledgements. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: February 17, 2023Accepted: March 3, 2023Published: April 20, 2023

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The authors declare that there are no conflicts of interest present.