Top

Published in:

01-07-2016 | Original Communication

Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal

Authors: Jean-Baptiste Davion, M. Cambron, E. Duhin, A. Chouraki, A. Lacour, P. Labauge, C. Carra, X. Ayrignac, P. Vermersch

Published in: Journal of Neurology | Issue 7/2016

Abstract

We report two cases of primary progressive multiple sclerosis (PPMS) included in the INFORMS cohort, experiencing a relapse related to a single MRI gadolinium-enhancing lesion 3 months after fingolimod withdrawal. These two patients share similarities with relapsing-remitting multiple sclerosis cases described in the same situation, suggesting that the initiating process of the active demyelinating plaques is also present in PPMS, even without relapses, but may be triggered as fingolimod is withdrawn. Although the results of the INFORMS study suggest that fingolimod may not slow down the progression, some PPMS patients might still benefit from a disease-modifying treatment.

Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 46(4):907–911CrossRefPubMed

Lublin F, Miller DH, Freedman MS, Cree BAC, Wolinsky JS, Weiner H, Lubetzki C, Hartung H-P, Montalban X, Uitdehaag BMJ, Merschhemke M, Li B, Putzki N, Liu FC, Häring DA, Kappos L, INFORMS Study Investigators (2016) Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Lond Engl 387:1075–1084CrossRef

Havla JB, Pellkofer HL, Meinl I, Gerdes LA, Hohlfeld R, Kümpfel T (2012) Rebound of disease activity after withdrawal of fingolimod (FTY720) treatment. Arch Neurol 69(2):262–264CrossRefPubMed

Ghezzi A, Rocca MA, Baroncini D, Annovazzi P, Zaffaroni M, Minonzio G, Comi G, Filippi M (2013) Disease reactivation after fingolimod discontinuation in two multiple sclerosis patients. J Neurol 260(1):327–329CrossRefPubMed

Berger B, Baumgartner A, Rauer S, Mader I, Luetzen N, Farenkopf U, Stich O (2015) Severe disease reactivation in four patients with relapsing-remitting multiple sclerosis after fingolimod cessation. J Neuroimmunol 282:118–122CrossRefPubMed

Hakiki B, Portaccio E, Giannini M, Razzolini L, Pastò L, Amato MP (2012) Withdrawal of fingolimod treatment for relapsing-remitting multiple sclerosis: report of six cases. Mult Scler Houndmills Basingstoke Engl 18(11):1636–1639CrossRef

Confavreux C, Vukusic S (2006) Natural history of multiple sclerosis: a unifying concept. Brain J Neurol 129(Pt 3):606–616CrossRef

Antel J, Antel S, Caramanos Z, Arnold DL, Kuhlmann T (2012) Primary progressive multiple sclerosis: part of the MS disease spectrum or separate disease entity? Acta Neuropathol (Berl.) 123(5):627–638CrossRef

Jacques FH (2015) Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology 84(9):963CrossRefPubMed

10.

Hawker K, O’Connor P, Freedman MS, Calabresi PA, Antel J, Simon J, Hauser S, Waubant E, Vollmer T, Panitch H, Zhang J, Chin P, Smith CH, OLYMPUS Trial Group (2009) Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial. Ann Neurol 66(4):460–471CrossRefPubMed

Title: Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal
Authors: Jean-Baptiste Davion
M. Cambron
E. Duhin
A. Chouraki
A. Lacour
P. Labauge
C. Carra
X. Ayrignac
P. Vermersch
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 7/2016
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-016-8144-x

At a glance: The STEP trials

Springer Medicine

Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 7/2016

A double-blind, randomized, cross-over, placebo-controlled, pilot trial with Sativex in Huntington’s disease

An unusual case of acquired pedophilic behavior following compression of orbitofrontal cortex and hypothalamus by a Clivus Chordoma

Validation of a clinical practice-based algorithm for the diagnosis of autosomal recessive cerebellar ataxias based on NGS identified cases

Incidence and course of depression in multiple sclerosis in the multinational BEYOND trial

Variants of windmill nystagmus

Effect of high-frequency repetitive transcranial magnetic stimulation on major depressive disorder in patients with Parkinson’s disease