Obesity linked to increased risk of paediatric multiple sclerosis

  • JAMA Neurol

  • International Clinical Digest
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Takeaway

  • Risk for multiple sclerosis (MS) in paediatric populations is linked to obesity, and obesity is also a factor in poor response to first-line therapies for MS, likely because of altered pharmacokinetics.

Why this matters

  • Children with obesity and MS need support in weight reduction or consideration of treatment relative to weight.

Key results

  • Almost a third (27.8%) of children had a BMI above the 90th percentile at their MS diagnosis.
  • Obesity was linked to doubled odds for MS (ORs; 95% CIs):
    • For girls: 2.19 (1.5-3.1; P<.001>
    • For boys: 2.14 (1.3-3.5; P=.003).
  • Relapse risk on interferon or glatiramer acetate therapy was also higher among children with obesity vs those with normal weight (annualised relapse rates; 95% CIs):
    • 1.29 (1.1-1.6) vs 0.72 (0.6-0.8; P<.001 respectively.>
  • A trend to increased risk for needing second-line treatment also found with obesity vs with normal weight:
    • 56.8% vs 38.7% (P=.06).

Study design

  • Single-center, retrospective study, 453 paediatric patients at a German MS centre.
  • Funding: None disclosed.

Limitations

  • Single, tertiary-care centre.