Yara Dadalti Fragoso1, Tim Spelman2, Cavit Boz3, Raed Alroughani4, Alessandra Lugaresi5, Steve Vucic6, Helmut Butzkueven7, Murat Terzi8, Eva Havrdova9, Dana Horakova9, Franco Granella10, Javier Olascoaga11, José Luis Sánchez-Menoyo12, Eugenio Pucci13, Michael Barnett14, Joseph Bruno B Brooks15, Jodi Haartsen16. 1. Department of Neurology, Universidade Metropolitana de Santos, Rua da Constituição 374, CEP 11015-470, Santos, SP, Brazil. Electronic address: yara@bsnet.com.br. 2. Department of Neurology, Royal Melbourne Hospital, Parkville, Australia. 3. Karadeniz Technical University, Trabzon, Turkey. 4. Department of Medicine, Division of Neurology, Amiri Hospital, Kuwait City, Kuwait. 5. MS Center, Department of Neuroscience and Imaging, University 'G. d'Annunzio', Chieti, Italy. 6. Westmead Hospital, Sydney, Australia. 7. Department of Neurology, Royal Melbourne Hospital, Parkville, Australia; Box Hill Hospital, Eastern Health, Melbourne, Australia. 8. Mayis University, Samsun, Turkey. 9. Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital and Charles University in Prague, Czech Republic. 10. Department of Neuroscience, University of Parma, Parma, Italy. 11. Hospital Donostia, Donostia, Gipuzkoa, Spain. 12. Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, Spain. 13. Neurology Unit, ASUR Marche - AV3, Macerata, Italy. 14. Brain and Mind Research Centre, Sydney, Australia. 15. Department of Neurology, Universidade Metropolitana de Santos, Rua da Constituição 374, CEP 11015-470, Santos, SP, Brazil. 16. Box Hill Hospital, Eastern Health, Melbourne, Australia.
Abstract
BACKGROUND: Fingolimod is an efficient and safe drug for treating relapsing-remitting multiple sclerosis (RRMS). In vivo, fingolimod is phosphorylated and binds to "sphingosine-1-phosphate"(S1P) receptors that are expressed in a wide range of cells, including lymphocytes. Under the effect of fingolimod, lymphocytes are retained in lymphoid tissues through the regulation of S1P1 receptors. The aim of the present study was to assess whether the degree of lymphopenia was correlated to the positive treatment response of RRMS patients with fingolimod. METHODS: Data was sourced from the MSBase Registry. Patients were divided into two groups, according to the lymphocyte count on peripheral blood examination. Annualized Relapse Rate (ARR), time to first relapse and time to six-month confirmed disability progression were compared between groups. RESULTS: Group one consisted of 202 patients who reached 750 lymphocytes/mm3 during treatment while the comparison group two included 101 patients who never reached less than 1000 lymphocytes/mm3 in peripheral blood during the observation period. There were no differences between groups in ARR, time to first relapse or time to six-month confirmed disability progression. CONCLUSION: The degree of lymphopenia in peripheral blood was not associated to the positive treatment response of fingolimod in RRMS patients.
BACKGROUND:Fingolimod is an efficient and safe drug for treating relapsing-remitting multiple sclerosis (RRMS). In vivo, fingolimod is phosphorylated and binds to "sphingosine-1-phosphate"(S1P) receptors that are expressed in a wide range of cells, including lymphocytes. Under the effect of fingolimod, lymphocytes are retained in lymphoid tissues through the regulation of S1P1 receptors. The aim of the present study was to assess whether the degree of lymphopenia was correlated to the positive treatment response of RRMS patients with fingolimod. METHODS: Data was sourced from the MSBase Registry. Patients were divided into two groups, according to the lymphocyte count on peripheral blood examination. Annualized Relapse Rate (ARR), time to first relapse and time to six-month confirmed disability progression were compared between groups. RESULTS: Group one consisted of 202 patients who reached 750 lymphocytes/mm3 during treatment while the comparison group two included 101 patients who never reached less than 1000 lymphocytes/mm3 in peripheral blood during the observation period. There were no differences between groups in ARR, time to first relapse or time to six-month confirmed disability progression. CONCLUSION: The degree of lymphopenia in peripheral blood was not associated to the positive treatment response of fingolimod in RRMS patients.
Authors: Edward J Fox; Fred D Lublin; Jerry S Wolinsky; Jeffrey A Cohen; Ian M Williams; Xiangyi Meng; Marina Ziehn; Scott Kolodny; Bruce A C Cree Journal: Neurol Neuroimmunol Neuroinflamm Date: 2019-09-11