- Title
- Multiple Sclerosis Relapses Following Cessation of Fingolimod
- Creator
- Malpas, Charles B.; Roos, Izanne; Havrdova, Eva Kubala; Izquierdo, Guillermo; Eichau, Sara; Hodgkinson, Suzanne; Grammond, Pierre; Lechner-Scott, Jeannette; Kalincik, Tomas; MSBase Study Group,; Sharmin, Sifat; Buzzard, Katherine; Skibina, Olga; Butzkueven, Helmut; Kappos, Ludwig; Patti, Francesco; Alroughani, Raed; Horakova, Dana
- Relation
- Clinical Drug Investigation Vol. 42, Issue 4, p. 355-364
- Publisher Link
- http://dx.doi.org/10.1007/s40261-022-01129-7
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: There is growing interest in the issue of disease reactivation in multiple sclerosis following fingolimod cessation. Relatively little is known about modifiers of the risk of post-cessation relapse, including the delay to commencement of new therapy and prior disease activity. Objective: We aimed to determine the rate of relapse following cessation of fingolimod and to identify predictors of relapse following cessation. Methods: Data were extracted from the MSBase registry in March 2019. Inclusion criteria were (a) clinically definite relapsing multiple sclerosis, (b) treatment with fingolimod for ≥ 12 months, (c) follow-up after cessation for ≥ 12 months, and (d) at least one Expanded Disability Status Scale score recorded in the 12 months before cessation. Results: A total of 685 patients were identified who met criteria. The mean annualised relapse rate was 1.71 (95% CI 1.59, 1.85) in the year prior to fingolimod, 0.50 (95% CI 0.44, 0.55) on fingolimod and 0.43 (95% CI 0.38, 0.49) after fingolimod. Of these, 218 (32%) patients experienced a relapse in the first 12 months. Predictors of a higher relapse rate in the first year were: younger age at fingolimod cessation, higher relapse rate in the year prior to cessation, delaying commencement of new therapy and switching to low-efficacy therapy. Conclusions: Disease reactivation following fingolimod cessation is more common in younger patients, those with greater disease activity prior to cessation and in those who switch to a low-efficacy therapy.
- Subject
- multiple sclerosis; fingolimod; disease reactivation; relapse
- Identifier
- http://hdl.handle.net/1959.13/1492328
- Identifier
- uon:53300
- Identifier
- ISSN:1173-2563
- Language
- eng
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