Friday, 26 June 2015

Heart Rate on Fingolimod

Simula S, Laitinen T, Laitinen TM, Tarkiainen T, Hartikainen JE, Hartikainen P. Effects of Three Months Fingolimod Therapy on Heart Rate. J Neuroimmune Pharmacol. 2015. [Epub ahead of print]

Fingolimod is a novel disease-modifying drug for relapsing-remitting multiple sclerosis (RRMS). Fingolimod initiation associates with a decrease in heart rate (HR). However, the long-term effects of fingolimod on HR are not known. The aim of this study was prospectively investigate the effect of 3-month fingolimod therapy on HR. Twenty-seven RRMS patients underwent 24-h ambulatory electrocardiogram recording 20 ± 16 days before (baseline) and at the day of fingolimod initiation (1 day). Twenty-four patients completed 3 months follow-up (3 months). The average HR over 24-h and the average HR for day-time and night-time were assessed at baseline, 1 day and 3 months. Fingolimod initiation resulted in slowing of HR from 82 ± 11 1/min at baseline to 63 ± 9.5 1/min at 5 h after the initiation of the therapy. The average HR during 24-h was lower at 1d (66 ± 7.8 1/min;p < 0.001) and also at 3 months (69 ± 8.3 1/min;p < 0.001) as compared to baseline (74 ± 10 1/min). The average daytime HR at 1 day (68 ± 8.4 1/min) was lower as compared to baseline (78 ± 11 1/min, p < 0.001), whereas no difference was found between the average daytime HR at baseline and at 3 months (79 ± 10 1/min). The average night-time HR at 1 day (59 ± 8.8 1/min;p < 0.001) and at 3 months (60 ± 9.2 1/min;p < 0.05) both were lower than at baseline (64 ± 9.9 1/min). In conclusion, fingolimod resulted in HR decrease reaching the nadir at 5 h after the first dose. HR remained lower after 3 months fingolimod treatment as compared to baseline. Particularly, HR at daytime recovered whereas the night-time HR showed not recovery as compared to the day of fingolimod. initiation.

Fingolimod can drop you heart rate and this is why you get your first dose in hospital.In this study they found that heart rate at night remained low although your day rate returned.


  1. Isn't a low heart rate a good thing? My resting heart rate is about 84. I try to use a cross-trainer every day in the hope of getting it lower but my muscle weakness means I'm finding it hard to do this vigorously enough to get fitter. I have my pulse taken when I have Tysabri and it is always a depressing experience.

  2. I think the problem is that with exercise, it's lower for a *good* reason. However, with Fingolimod, they don't know for certain why it's lower. The reason could be not so good. Remember - the lowest heart rate = death.

  3. Do they mention when they were taking their fingolimod? Current practice in the US is to have you take it before bed so you sleep through the lowered heart rate, but I found that it caused me to wake up with an odd flutter. So I switched to the morning and then never had that problem again.


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