6533b834fe1ef96bd129e24c

RESEARCH PRODUCT

Clinical activity after fingolimod cessation: Disease reactivation or rebound?

S La GioiaB ForciSabrina RealmutoPietro AnnovazziArianna SartoriRoberta GrassoCinzia CordioliM. L. StromilloR LanzilloB. FrigeniEleonora Cocco 2Elisabetta SignorielloAlessio SignoriSandro RossiGiuseppe FenuM. P. SormaniDamiano BaronciniG. T. ManiscalcoSarah RasiaJessica Frau

subject

AdultMalemedicine.medical_specialtyAdolescentDiseaseCohort StudiesMultiple sclerosisImmunosuppressive AgentYoung Adult03 medical and health sciencesMultiple Sclerosis Relapsing-Remitting0302 clinical medicineRecurrenceInternal medicineHumansMedicine030212 general & internal medicineFingolimod; Multiple sclerosis; Reactivation; Rebound; Neurology; Neurology (clinical)Natural courseReboundFingolimod Hydrochloridebusiness.industryMultiple sclerosisFingolimodmedicine.diseaseReactivationMagnetic Resonance ImagingFingolimodDiscontinuationItalyWithholding TreatmentNeurologymultiple sclerosiCohortFemaleNeurology (clinical)Cohort StudiebusinessImmunosuppressive Agents030217 neurology & neurosurgeryHumanmedicine.drug

description

Background and purpose There is debate as to whether the apparent rebound after fingolimod discontinuation is related to the discontinuation itself or whether it is due to the natural course of highly active multiple sclerosis (MS). Our aim was to survey the prevalence of severe reactivation and rebound after discontinuation of fingolimod in a cohort of Italian patients with MS. Methods Patients with relapsing-remitting MS who were treated with fingolimod for at least 6 months and who stopped treatment for reasons that were unrelated to inefficacy were included in the analysis. Results A total of 100 patients who had discontinued fingolimod were included in the study. Fourteen patients (14%) had a relapse within 3 months after fingolimod discontinuation, and an additional 12 (12%) had a relapse within 6 months. According to this study's criteria, 10 patients (10%) had a severe reactivation. Amongst these patients, five (5%) had a reactivation that was considered to be a rebound. Conclusions The present study showed that more than 26% of patients are at risk of having a relapse within 6 months after fingolimod discontinuation. Nevertheless, the risk of severe reactivations and rebound is lower than has been previously described.

10.1111/ene.13694http://hdl.handle.net/11567/925034