Key clinical point: The average relapse rates and the rate of severe relapses did not increase significantly after fingolimod discontinuation in patients with relapsing multiple sclerosis (MS); however, delaying the commencement of immunotherapy increased the risk for relapse.
Major finding: The annualized relapse rate (ARR) was not significantly different during and after fingolimod cessation (mean difference −0.06; 95% CI −0.14 to 0.01), with no severe relapses reported in the year prior and after fingolimod cessation. However, delaying the recommencement of therapy from 2 to 4 months vs. beginning within 2 months (odds ratio 1.67; 95% CI 1.22-2.27) was associated with a higher risk for relapse.
Study details: Findings are from an analysis of 685 patients with relapsing MS who received fingolimod therapy for at least 12 months and were followed-up for at least 12 months after fingolimod cessation.
Disclosures: Open access funding was enabled by CAUL and its member institutions . Some authors declared receiving research support, personal compensation, speaker or consulting fees, or nonfinancial support from various sources.
Source: Malpas CB et al. Multiple sclerosis relapses following cessation of fingolimod. Clin Drug Investig. 2022;42:355-364 (Mar 18). Doi: 10.1007/s40261-022-01129-7