Medication for Multiple Sclerosis in Children

Medication can effectively manage flare-ups, reduce symptoms, and slow the progression of multiple sclerosis, or MS, in children. This is called disease modifying therapy.

Physicians at Hassenfeld Children’s Hospital at NYU Langone may discuss starting medication for MS after a child is diagnosed and has experienced a first episode of neurological symptoms that last at least 24 hours. Studies show that beginning medications early can prevent or prolong the time before the next attack. It may also slow the formation of new lesions in the brain or spinal cord.

Medication management is an important part of treatment for children with MS. Our physicians work with you and your child to manage any side effects of these long-term medications.

Disease modifying MS medications are taken by injection, by mouth, or through a vein using intravenous (IV) infusion.

Injectable Medications

To reduce the frequency and severity of relapses, your child’s doctor may prescribe injectable medications. These medications are injected under the skin or into muscle.

Ofatumumab (brand name Kesimpta) is a monoclonal antibody that binds to some immune B cells and depletes them. This medication can cause a decrease in neutrophils, a type of white blood cell, and may require regular blood tests.

Different interferon medications are given with different frequencies—injections every other day, three times a week, once weekly, or twice per month. Interferons can cause changes in the liver, so children who take these medications need regular blood tests. Glatiramer acetate, another injectable medication, does not require monitoring with blood tests.

Oral Medications

Your child’s doctor may prescribe disease modifying medications, such as dimethyl fumarate, ozanimod, ponesimod, siponimod, fingolimod, teriflunomide and cladribine that are taken by mouth. These medications can help to reduce the number of relapses.

Oral medications are taken either once or twice a day. The doctor monitors your child for side effects, such as a reduced number of white blood cells, high blood pressure, liver changes, and blurred vision.

Infusion Medications

Natalizumab (Tysabri) is a disease modifying medication that is given through a vein using IV infusion in a doctor’s office on a monthly basis. It helps prevent potentially damaging immune cells from leaving the bloodstream and entering the central nervous system.

Ocrelizumab (Ocrevus) and ublituximab (Briumvi) work by depleting B cells, which are part of the immune system. If one of these medications is recommended, your child will receive infusions twice a year. Blood tests are required prior to each infusion.

Medications for Relapse

During a child’s MS flare-up—also called a relapse, attack, or exacerbation—doctors may prescribe a high dose of a corticosteroid, such as methylprednisolone, to be delivered daily through an IV infusion for three to five days. This can help to shorten the attack by reducing nerve inflammation.

If your child has severe symptoms that do not respond to corticosteroids, the doctor may then recommend other treatments, such as plasma exchange.