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Abstract
Background Multiple Sclerosis (MS) is a chronic, inflammatory and degenerative disease, which affects the Central Nervous System [1].
Fingolimod (FTY) is a medicine indicated in the treatment of MS patients with active exacerbation/remitting episodes. Being an expensive, innovative treatment it has been the subject of careful monitoring.
Purpose To evaluate the use of FTY between May 2011 and September 2012. To evaluate the benefits in reducing disease progression.
Materials and Methods Retrospective analysis of FTY use in MS patients in outpatient care, followed in Demyelinating Diseases Consultation. The number of outbreaks and Kurtzke Expanded Disability Status Scale (EDSS) scores, blood pressure and heart rate were examined using a pharmacy database and patients’ medical records.
Results Twenty six patients were investigated:
Previous treatment: 10 patients with natalizumab (4 for over 2 years), 8 with interferon beta (IFNβ) (6 of them for more than 1 year), 3 with glatiramer acetate (GA), 3 with azathioprine with mycophenolate mofetil and 1 with methotrexate.
FTY treatment periods: 4 patients had started <1 month ago; 18 between 1–6 months; 3 between 6–12 months and one >1 year.
Vital parameters: mean arterial pressure (MAP): 121.29 mmHg/70.41 mmHg and 113.06 mmHg/68.31 mmHg after 6 h of administration. The mean heart rate (MHR): 71.06 beats/min and 62.53 beats/min after 6 h.
Disease progression: 1 patient suffered only one flare-up. Nine patients had a mean decrease of 0.72 in the EDSS scale and 4 maintained the values. There was no increase in lesion extension in Nuclear Magnetic Resonance.
Average monthly costs: FTY €1,872.5; INFβ/GA (1st line) €843.91; natalizumab €1,923.90 (costs related to the route of administration were not counted).
Conclusions There was no worsening of symptoms after introduction of FTY and there was only one recrudescence episode, requiring long-term assessment.
Despite costing more than first-line medicines, FTY was the best option because it is an oral formulation, so is more convenient for patients.
Reference
Portuguese Society of Multiple Sclerosis
No conflict of interest.