Fingolimod Rebound: A Review of the Clinical Experience and Management Considerations
Autor: | April Erwin, Carlo Tornatore, Jessica Stevens, Brian Barry |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Neurology Review Disease lcsh:RC346-429 Multiple sclerosis 03 medical and health sciences 0302 clinical medicine Natalizumab medicine Disease-modifying therapy 030212 general & internal medicine Relapse Intensive care medicine lcsh:Neurology. Diseases of the nervous system Pregnancy Rebound business.industry Fingolimod medicine.disease Discontinuation Clinical trial Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
Zdroj: | Neurology and Therapy, Vol 8, Iss 2, Pp 241-250 (2019) Neurology and Therapy |
ISSN: | 2193-6536 2193-8253 |
DOI: | 10.1007/s40120-019-00160-9 |
Popis: | Because the treatment of multiple sclerosis (MS) may span decades, the need often arises to make changes to the treatment plan in order to accommodate changing circumstances. Switching drugs, or the discontinuation of immunomodulatory agents altogether, may leave patients vulnerable to relapse or disease progression. In some cases, severe MS disease activity is noted clinically and on MRI after treatment withdrawal. When this disease activity is disproportionate to the pattern observed prior to treatment initiation, patients are said to have experienced rebound. Of the US Food and Drug Administration (FDA)-approved agents to treat MS, the drugs most commonly implicated in rebound are natalizumab and fingolimod. In this review based on the reported cases and data from clinical trials, we characterize disease rebound after fingolimod cessation. We also outline fingolimod rebound management considerations, summarizing what evidence is available to help clinicians mitigate the risk of rebound, switch therapies, and treat rebound events when they occur. The commonly encountered situation of fingolimod discontinuation prior to pregnancy is also discussed. |
Databáze: | OpenAIRE |
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