TOPLINE

Pediatric-onset multiple sclerosis (MS) incidence in Netherlands increased from 0.26 per 100,000 person-years in 2011-2016 to 0.40 per 100,000 person-years in 2017-2025.

METHODOLOGY

• Researchers used data from a prospective study and referrals to a Dutch MS center to update incidence rates of pediatric acquired demyelinating syndromes (ADS) and to assess temporal changes around the COVID pandemic.
• They included children younger than 18 years with a first demyelinating event in Netherlands between January 2017 and June 2025.
• Diagnoses comprised MS, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4+ NMOSD), and seronegative ADS.

TAKEAWAY

• The study included 257 children with a first demyelinating event: 111 had MS, 93 had MOGAD, 5 had AQP4+ NMOSD, and 48 had seronegative ADS.
• Overall ADS incidence was 0.91 per 100,000 person-years, with MS at 0.40, MOGAD at 0.33, AQP4+ NMOSD at 0.02, and seronegative ADS at 0.16 per 100,000 person-years.
• Compared with 2011-2016, MS incidence increased from 0.26 to 0.40 per 100,000 person-years in 2017-2025.
• MS incidence declined after schools reopened and most COVID restrictions were lifted in January 2022, followed by a modest increase in 2025 mainly in adolescents. MOGAD incidence increased modestly among younger children during the restriction period.

IN PRACTICE

"While caution is warranted given the relatively small numbers, these findings underscore the importance of long-term surveillance and the further need for studies in larger cohorts to validate these trends and elucidate the mechanisms linking viral exposure to paediatric demyelinating disease," the authors of the study wrote.

SOURCE

The study was led by Sandy Molenaar, Erasmus University Medical Centre in Rotterdam, Netherlands. It was published online on August 3 in the European Journal of Neurology.

LIMITATIONS

The relatively low number of cases limited formal statistical analysis of trends. Follow-up duration in recent years was relatively short for MS. The post-COVID period covered was relatively brief.

DISCLOSURES

The study was supported by Stichting MS Research and Postcodeloterij. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.