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Neurology and Therapy
Published in: Neurology and Therapy 2/2019

Open Access 01-12-2019 | Multiple Sclerosis | Review

Fingolimod Rebound: A Review of the Clinical Experience and Management Considerations

Authors: Brian Barry, April A. Erwin, Jessica Stevens, Carlo Tornatore

Published in: Neurology and Therapy | Issue 2/2019

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Abstract

Because the treatment of multiple sclerosis (MS) may span decades, the need often arises to make changes to the treatment plan in order to accommodate changing circumstances. Switching drugs, or the discontinuation of immunomodulatory agents altogether, may leave patients vulnerable to relapse or disease progression. In some cases, severe MS disease activity is noted clinically and on MRI after treatment withdrawal. When this disease activity is disproportionate to the pattern observed prior to treatment initiation, patients are said to have experienced rebound. Of the US Food and Drug Administration (FDA)-approved agents to treat MS, the drugs most commonly implicated in rebound are natalizumab and fingolimod. In this review based on the reported cases and data from clinical trials, we characterize disease rebound after fingolimod cessation. We also outline fingolimod rebound management considerations, summarizing what evidence is available to help clinicians mitigate the risk of rebound, switch therapies, and treat rebound events when they occur. The commonly encountered situation of fingolimod discontinuation prior to pregnancy is also discussed.
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Metadata
Title
Fingolimod Rebound: A Review of the Clinical Experience and Management Considerations
Authors
Brian Barry
April A. Erwin
Jessica Stevens
Carlo Tornatore
Publication date
01-12-2019
Publisher
Springer Healthcare
Published in
Neurology and Therapy / Issue 2/2019
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI
https://doi.org/10.1007/s40120-019-00160-9

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