Background Multiple sclerosis (MS) is in Europe the most common neurological disease starting between the ages of 20 and 40 years. It affects approximately 2.5 million people worldwide and is the first cause of non-traumatic disability for young people. Management of this disease has for a long time been limited to treatment of relapses. However, in recent years, significant progresses have been made in the treatment with the appearance of, among others, fingolimod for relapsing-remitting MS in March 2011 in the European Union.
Purpose To observe the impact of fingolimod in the care of patients, and make an assessment of practise in the neurology unit (Professor Pelletier, La Timone hospital, Marseille) one year after fingolimod was approved for use.
Materials and Methods We noted treatment interruptions and their causes, and analysed benefits and side effects reported by patients treated with fingolimod for more than three months. Data collection was based on meetings or telephone interviews with patients and on information taken from medical records.
Results 143 patients started treatment with fingolimod between March 2011 and October 2012, 51 in the last three months. Our analysis was performed on 92 patients, and included 19 meetings and 20 telephone interviews. Four definitive treatment interruptions were identified: three for disease progression (relapses) and one hepatic cytolysis. We also noted two temporary discontinuations for tuberculosis contagion and hives. Preliminary results show that the clinical and biological tolerance was satisfactory in most cases. Furthermore, absence of relapse or improvements in motor status and tiredness were noted by the majority.
Conclusions Fingolimod has changed the management of patients with MS, and many of them have reported an improvement in their quality of life and feel side effects to be acceptable. The imminent arrival of other oral agents should result in clarification of the role of each in the strategy, and might be the subject of comparative studies.
No conflict of interest.
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