Huppke B, Ellenberger D, Hummel H, et al. - In this single-center retrospective study, researchers examined a pediatric population in Germany to determine the link of obesity with multiple sclerosis (MS) risk and response to first-line treatment in this population. They analyzed 453 patients suffering from relapsing-remitting pediatric MS and in whom body mass index (BMI) measurement was obtained within 6 months of diagnosis. They used German BMI references to stratify the data on BMIs by gender and age and performed comparisons with the BMI data of 14,747 controls from a nationwide child health survey for odds ratio estimates. They found a link of obesity with twofold greater odds of the disease and more frequent failure of first-line therapy with interferon beta-1a or 1b and glatiramer acetate, this led to a rise in the number of patients receiving second-line therapy. In this study, elevated pediatric MS risk seemed to be related to obesity, and good response to first-line medications was absent in obese patients; modified pharmacokinetics seemed to be the most probable factors in treatment response, indicating that therapy response could be improved by attaining healthy weight or adjusting the dose according to BMI.