Sunday, 24 January 2010

Oral Fingolimod or Intramuscular Interferon for Relapsing Multiple Sclerosis

In patients with relapsing–remitting multiple sclerosis, oral fingolimod was more effective than intramuscular interferon beta-1a in reducing relapse rates. Adverse events associated with fingolimod included herpes virus infections, atrioventricular block, macular edema, skin cancer, and liver-enzyme elevation.

http://content.nejm.org/cgi/content/full/NEJMoa0907839

3 comments:

  1. While it might look as if those currently on the injectibles will get a more convenient method of taking medication (tablet form), we are left with another choice - which of the oral treatments? Fingolimod looks slightly more effective, but Cladribine looks slightly better in term of side effects. Tysabri is another option, but comes with the increasing PML risk. How on earth can a patient make an informed decision given some many variables (convenience / efficacy / safety etc)!

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  2. I say none of the above. I was diagnosed with MS about four years ago and I've been on Avonex, Copaxone and Tysabri with little to no success. I'm on a pill right now called low-dose naltrexone (LDN). It's used off label for autoimmune diseases like mine. I've been on it eight months, and it has done more for me than any conventional medication. I say there's already an oral medication out there for patients. Plus, LDN doesn't have the side effects like the other ones. I encourage a discussion among doctors and their patients about this medication.

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  3. The problem with LDN is that we need class 1 evidence that it works. As a clinician it is difficult to prescribe something without knowing if it really works or not. However, I do agree that there is a scientific rationale for its use in MS, which is why we need randomised controlled trials.

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