In a real-world population, fingolimod initiation was predominantly uneventful; clinical observations were similar to previous clinical trials, according to a study of 850 first-dose observations (FDOs). Researchers found:

• 78% of patients were female.

• Mean age at FDO was 40.1 years.

• Mean heart rate was 72.7 beats per minute (BPM) pre-dose, 64.3 BPM at 5 hours, and 66.1 BPM at 6 hours post-dose.

• New-onset heart block was seen in 2% of episodes.

• Patients were discharged after 6 hours in 97% of episodes; 3% of patients required extended monitoring.

• Overnight monitoring was required in 5 episodes.

• No episodes required pharmacological intervention or temporary cardiac pacing.

Citation: Datt J, Baldock L, Pull E, Webber B. The management and outcomes of fingolimod first dose cardiac monitoring in UK patients with relapsing-remitting multiple sclerosis. [Published online ahead of print October 28, 2015]. Mult Scler Rel Disord. doi: 10.1016/j.msard.2015.10.009.