open access

Vol 51, No 2 (2017)
Reviews
Submitted: 2016-10-06
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Severe disease exacerbations in patients with multiple sclerosis after discontinuing fingolimod

Anna Członkowska, Łukasz Smoliński, Tomasz Litwin
DOI: 10.1016/j.pjnns.2017.01.006
·
Neurol Neurochir Pol 2017;51(2):156-162.

open access

Vol 51, No 2 (2017)
Reviews
Submitted: 2016-10-06

Abstract

Discontinuation of fingolimod in patients with multiple sclerosis (MS) can lead to disease reactivation. In this review, we describe cases of severe exacerbations in patients with MS following discontinuation of fingolimod, including three cases from our center. We consider potential mechanisms of disease reactivation after cessation of fingolimod, and the evidence supporting this rebound effect. We conclude that discontinuation of fingolimod results in the return of disease activity, which then leads to severe exacerbations (i.e., rebounds) in a clinically significant proportion of patients. Lastly, we consider disease-modifying treatment options for patients who discontinue fingolimod.

Abstract

Discontinuation of fingolimod in patients with multiple sclerosis (MS) can lead to disease reactivation. In this review, we describe cases of severe exacerbations in patients with MS following discontinuation of fingolimod, including three cases from our center. We consider potential mechanisms of disease reactivation after cessation of fingolimod, and the evidence supporting this rebound effect. We conclude that discontinuation of fingolimod results in the return of disease activity, which then leads to severe exacerbations (i.e., rebounds) in a clinically significant proportion of patients. Lastly, we consider disease-modifying treatment options for patients who discontinue fingolimod.

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Keywords

Multiple sclerosis, Fingolimod, Withdrawal, immune reconstitution inflammatory syndrome

About this article
Title

Severe disease exacerbations in patients with multiple sclerosis after discontinuing fingolimod

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 2 (2017)

Pages

156-162

DOI

10.1016/j.pjnns.2017.01.006

Bibliographic record

Neurol Neurochir Pol 2017;51(2):156-162.

Keywords

Multiple sclerosis
Fingolimod
Withdrawal
immune reconstitution inflammatory syndrome

Authors

Anna Członkowska
Łukasz Smoliński
Tomasz Litwin

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