Severe relapses under fingolimod treatment prescribed after natalizumab

his research group from Italy looked at the rate of relapse following a change of treatment to fingolimod from natalizumab in 3 patients with relapsing-remitting MS. Fingolimod was started 3-4 months after natalizumab was stopped to help immune surveillance reconstitution and reduce the risk of postnatalizumab MS reactivation. The three patients developed severe MS reactivation 16 days, 19 days and 6 days after starting fingolimod.

These cases suggest that fingolimod is not effective in controlling rebound, when started 3-4 months after natalizumab cessation. More experience is needed to decide on the correct timing of switching patients from natalizumab to fingolimod.


Authors:
Centonze D, Rossi S, Rinaldi F, Gallo P.

Source:
Neurology. 2012 Oct 3. [Epub ahead of print]

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