Acute relapse after initiation of Siponimod in a patient with secondary progressive MS
| Autor: | Peter Sguigna, Paul Litvak, Kevin F. Kia, Shirley O’Leary, Fides M. Pacheco, Karanjit S. Kooner, Tresa Zacharias, Ellen Marder, Rehana Z. Hussain, Olaf Stüve |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Oncology Adult Male medicine.medical_specialty Neurology Multiple Sclerosis Sphingosine-1-phosphate receptor Vision Disorders 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Recurrence Internal medicine Benzyl Compounds medicine Humans Optic neuritis business.industry Multiple sclerosis medicine.disease Fingolimod Magnetic Resonance Imaging Discontinuation Clinical trial 030104 developmental biology Siponimod chemistry Immunology Azetidines Neurology (clinical) business 030217 neurology & neurosurgery Tomography Optical Coherence medicine.drug |
| Zdroj: | Journal of neurology. 263(3) |
| ISSN: | 1432-1459 |
| Popis: | Sphingosine 1-phosphate (S1P) is a signaling molecule that binds to five G protein-coupled receptors (Proc Natl Acad Sci USA 108:751-756, 2011). Modulation of these receptors has been associated with pleiotropic biological effects in the immune, cardiovascular, and central nervous systems (CNS). The functional S1P receptor antagonist fingolimod was the first member of this class of pharmacotherapeutics to be approved for treatment of relapsing multiple sclerosis (MS). Siponimod is currently in clinical trial in patients with secondary progressive (SP) MS, a clinical trial for which there is an unmet need for disease-modifying agents. 10 weeks into the trial, the patient awoke with blurry vision in his left eye, and was subsequently diagnosed with an acute optic neuritis. Despite discontinuation of siponimod and treatment with pulse corticosteroids, the patient did not regain visual function in the affected eye. This is the first report of disease reactivation shortly after initiating siponimod in a patient with SPMS. This case illustrates that the known changes in lymphocyte numbers and composition in the CNS associated with S1P receptor antagonism during the SPMS disease stage may have adverse outcomes in some patients during treatment initiation, and that close clinical and paraclinical monitoring is advised. |
| Databáze: | OpenAIRE |
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