Natalizumab Escalation Early in the Disease Course of Pediatric-Onset Multiple Sclerosis: Two Japanese Cases

This study investigates the timing and effectiveness of natalizumab treatment in two Japanese children with pediatric-onset multiple sclerosis who exhibited aggressive disease features. The authors highlight the use of advanced MRI metrics to assess disease severity and suggest that early escalation to high-efficacy therapy like natalizumab may lead to sustained clinical and radiologic stability in selected cases. The findings emphasize the need for further validation of pediatric thresholds for treatment escalation in this population.