J Frau1, M P Sormani2, A Signori2, S Realmuto3, D Baroncini4, P Annovazzi4, E Signoriello5, G T Maniscalco6, S La Gioia7, C Cordioli8, B Frigeni7, S Rasia8, G Fenu1, R Grasso9, A Sartori10, R Lanzillo11, M L Stromillo12, S Rossi13, B Forci14, E Cocco1. 1. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. 2. Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy. 3. Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy. 4. Multiple Sclerosis Study Centre, AO s. Antonio Abate, Gallarate, Italy. 5. Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy. 6. Neurological Clinic and Multiple Sclerosis Centre of 'AORN A.Cardarelli', Naples, Italy. 7. USC Neurologia, ASST Papa Giovanni XXIII, Bergamo, Italy. 8. Multiple Sclerosis Center, Spedali Civili of Brescia, Presidio di Montichiari, Brescia, Italy. 9. Neurologia Universitaria OORR, Foggia, Italy. 10. Clinica Neurologica, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Trieste, Trieste, Italy. 11. Department of Neurosciences, Reproductive Sciences and Odontostomatology, Multiple Sclerosis Centre, Federico II University, Naples, Italy. 12. Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy. 13. Neuroimmunology and Neuromuscular Diseases Unit, IRCCS Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. 14. Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria Careggi, Area del farmaco e Salute del bambino (NEUROFARBA), Florence, Italy.
Abstract
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.
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.
Authors: Jessica Frau; Francesco Saccà; Alessio Signori; Damiano Baroncini; Giuseppe Fenu; Pietro Annovazzi; Marco Capobianco; Elisabetta Signoriello; Alice Laroni; Sara La Gioia; Arianna Sartori; Giorgia Teresa Maniscalco; Simona Bonavita; Marinella Clerico; Cinzia Valeria Russo; Antonio Gallo; Caterina Lapucci; Antonio Carotenuto; Maria Pia Sormani; Eleonora Cocco Journal: J Neurol Date: 2019-06-17 Impact factor: 4.849
Authors: Carmen Alcalá; F Gascón; Francisco Pérez-Miralles; J A Domínguez; S Gil-Perotín; B Casanova Journal: J Neurol Date: 2019-01-19 Impact factor: 6.682