Advancements and Challenges in Pediatric Multiple Sclerosis Treatment: Lauren B. Krupp, MD

WATCH TIME: 3 minutes

"We now have therapies that are highly effective, and since young people with MS relapse or have clinical attacks more frequently than older people with MS, it's very important to get those therapies on board quickly."

Pediatric multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system, with onset occurring before the age of 18 years. It accounts for approximately between 3% to 5% of all MS cases and is characterized predominantly by a relapsing-remitting course, where periods of neurological symptoms are followed by remissions.¹ Diagnosis can be challenging because of overlapping symptoms with other pediatric neurological conditions. Early initiation of disease-modifying therapies may be crucial to manage relapses and delay progression. Beyond physical symptoms, pediatric MS can impact cognitive and emotional development, highlighting the importance of a multidisciplinary approach to care.

Recently, at the 2025 American Academy of Neurology (AAN) Annual Meeting, held April 5-9, in San Diego, California, a program offered a comprehensive overview of pediatric-onset MS, focusing on its distinct biological, clinical, and psychosocial features.² Led by experts Jennifer Graves, MD, PhD, and Lauren B. Krupp, MD, the session guided participants through the latest approaches to diagnosis and disease-modifying therapy selection, emphasizing the unique considerations required for treating children and adolescents. The program also explored the cognitive and emotional impacts of the disease, the role of rehabilitation and physical activity, and the influence of social determinants of health—aiming to equip clinicians with practical strategies for delivering holistic, patient-centered care.

Following the session, Krupp, director of the Multiple Sclerosis Comprehensive Care Center at NYU Langone Health, sat down with NeurologyLive^®. In the conversation, she highlighted the evolving treatment landscape for pediatric MS emphasizing the benefits of initiating high-efficacy therapies early because of the high relapse rates in younger patients. Krupp, who also serves as the Nancy Glickenhaus Pier Professor of Pediatric Neuropsychiatry at NYU Grossman School of Medicine, stressed the need to monitor for long-term risks such as infections associated with immunosuppressive therapies. Beyond clinical management, she discussed the psychosocial challenges faced by adolescents with MS and underscored the importance of multidisciplinary support to address emotional and social needs alongside medical care.

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REFERENCES
1. Brola W, Steinborn B. Pediatric multiple sclerosis - current status of epidemiology, diagnosis and treatment. Neurol Neurochir Pol. 2020;54(6):508-517. doi:10.5603/PJNNS.a2020.0069
2. Krupp LB. Pediatric MS: Causes and Consequences from an Ecological and Psychosocial Perspective. Presented at: 2025 AAN Annual Meeting; April 5-9; San Diego, CA. Treatment of Pediatric Multiple Sclerosis in the Current Era.

Editor’s Note: Krupp has disclosed that she has received personal compensation for serving as a Consultant for Bristol Myers Squibb, Celgene, Medscape, and EBIX. Krupp also has received personal compensation for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, and Hoffman LaRoche. She has received personal compensation for serving as an Expert Witness for MMMK and for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Krupp noted that she has received intellectual property interests from a discovery or technology relating to health care.