Fingolimod in Real Clinical Practice

Czech version

Authors: V. Tichá ¹; L. Sobíšek ²; E. Havrdová ¹
Authors‘ workplace: Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze ¹; Fakulta informatiky a statistiky, VŠE v Praze ²
Published in: Cesk Slov Neurol N 2017; 80/113(2): 213-219
Category: Short Communication
doi: https://doi.org/10.14735/amcsnn2017213

Overview

Aim:
To assess retrospectively the clinical efficacy of fingolimod in one or two years of treatment in patients with active multiple sclerosis.

Patients and methods:
223 patients were treated with fingolimod for at least one year, 109 of whom were treated for two years. 126 patients were switched to fingolimod from interferon beta or glatiramer acetate, 3 patients were treatment-naive and 94 patients were switched from natalizumab.

Results:
In patients switched from IFN beta or GA, the relapse rate decreased by 72% in the first year and by 64% in the first 2 years, in patients switched from natalizumab the decrease was 25% in the first year and 31% during 2 years of treatment. 66% of patients in the overall group and in both subgroups remained relapse-free during the first year of treatment and 50.5% over the 2 years of fingolimod treatment. 80% of patients had stable or improved EDSS in the first year and also after 2 years of treatment. 94.6% of patients did not have a 6-months confirmed disability progression within one or 2-year observational period. No evidence of clinical activity of the disease was observed in 64.6% of patients in the first year and in 50% of patients after the first 2 years of treatment. 16.7% of patients with the washout period of 63 days or less after the last infusion of natalizumab relapsed, while the washout period longer than 63 days led to a relapse in 25% of patients.

Conclusion:
Fingolimod is an effective escalation treatment in patients failing on DMDs or as the first line treatment in patients with high activity of MS. After termination of natalizumab treatment, fingolimod is an effective alternative for the majority of patients.

Key words:
multiple sclerosis – fingolimod – natalizumab – escalation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

芬戈莫德在临床中的实际应用

目标：

回顾性评估芬戈莫德在一年或两年治疗活动性多发性硬化症（MS）患者中的临床疗效。

患者和方法：

223名患者用芬戈莫德治疗至少一年，其中109例接受治疗两年。 126名患者从干扰素β（IFN）或醋酸格拉默（GA）转为芬戈莫德，3名患者为无创性治疗，94名患者从那他珠单抗切换。

结果：

在从IFNβ或GA转换的患者中，第一年的复发率下降了72％，前2年的复发率下降了64％，从那他珠单抗转移的患者第一年下降了25％，2年内治疗下降了31％。整个组和两亚组66％的患者在治疗的第一年仍无复发，而在芬戈莫德治疗的2年中仍为50.5％。 80％的患者在第一年和治疗2年后均有稳定或改善的EDSS。 94.6％的患者在一年或两年观察期内没有6个月确诊的残疾进展。在第一年64.6％的患者和治疗前2年的50％患者中没有观察到该疾病的临床活动证据。最后一次输注natalizumab后，16.7％的清除期为63天或更少的患者复发，而超过63天的清除期导致25％的患者复发。

结论：

芬戈莫德是一种有效的升级治疗，在DMD患者失败或作为MS高活动度患者的第一线治疗。在那他珠单抗治疗终止后，芬戈莫德是大多数患者的有效选择。

关键词：

多发性硬化 - 芬戈莫德 - 那他珠单抗 - 升级

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