Sunday, 10 January 2016

Fingolimod in real life

Rasenack M, Rychen J, Andelova M, Naegelin Y, Stippich C, Kappos L, Lindberg RL, Sprenger T, Derfuss T. Efficacy and Safety of Fingolimod in an Unselected Patient Population.
PLoS One. 2016 Jan 6;11(1):e0146190. doi:10.1371/journal.pone.0146190. eCollection 2016.


BACKGROUND: Fingolimod is a first in class oral compound approved for the treatment of relapsing-remitting multiple sclerosis (RR-MS). The aim of this study was to evaluate clinical and neuroradiological responses to fingolimod as well as the safety and tolerability in RR-MS patients in clinical practice. In addition, a panel of pro-inflammatory serum cytokines was explored as potential biomarker for treatment response.
METHODS:We conducted a retrospective, non-randomized, open-label, observational study in 105 patients with RR-MS and measured cytokines in longitudinal serum samples.
RESULTS:Compared to the year before fingolimod start the annualized relapse rate was reduced by 44%. Also, the percentage of patients with a worsening of the EDSS decreased. Accordingly, the fraction of patients with no evidence of disease activity (no relapse, stable EDSS, no new active lesions in MRI) increased from 11% to 38%. The efficacy and safety were comparable between highly active patients or patients with relevant comorbidities and our general patient population.
CONCLUSIONS:The efficacy in reducing relapses was comparable to that observed in the phase III trials. In our cohort fingolimod was safe and efficacious irrespective of comorbidities and previous treatment.
So more evidence that real life reflects that which occurred in clinical trials. The data indicate that we need to be able to do better as 62% of people still had disease activity

CoI: None relevant 

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