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 MS Base 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

Multiple Sclerosis Relapses Following Cessation of Fingolimod

Patti, Francesco;
2022-01-01

Abstract

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 MS Base 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
File in questo prodotto:
File Dimensione Formato  
Multiple Sclerosis Relapses Following Cessation of Fingolimod.pdf

accesso aperto

Tipologia: Versione Editoriale (PDF)
Dimensione 889.7 kB
Formato Adobe PDF
889.7 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/548323
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 9
social impact