Neurol. praxi. 2014;15(5):274-277

Escalation therapy with fingolimod in a patient with familial multiple sclerosis. A case report

MUDr. Jiří Piťha
MS Centrum Teplice, Neurologické oddělení KZ a.s. &ndash, Nemocnice Teplice o. z.

The article reports on the management of a patient with relapsing-remitting multiple sclerosis in daily clinical practice. The first-choice treatment with interferon beta 1a had initially appeared successful; due to a rising level of neutralizing antibodies and a negative induction test with myxovirus resistance protein A, the patient was switched to glatiramer acetate. He developed local intolerance to treatment at its initiation. Two severe relapses with an increase in EDSS (Expanded Disability Status Scale) of 2 points occurred. Magnetic resonance imaging of the brain revealed two enhancing foci on postcontrast images. We suppose that increased disease activity occurred with latency as a result of inefficacy of interferon beta due to neutralizing antibodies. Given the JC virus positivity and previous immunosuppressive therapy, treatment with fingolimod was chosen.

Keywords: sclerosis multiplex, escalation of therapy, fingolimod, interferone beta 1 a, glatiramer acetate

Published: November 18, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Piťha J. Escalation therapy with fingolimod in a patient with familial multiple sclerosis. A case report. Neurol. praxi. 2014;15(5):274-277.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Calabresi PA, Radue EW, Goodin D, Jeffery D, Rammohan KW, Reder AT, Vollmer T, Agius MA, Kappos L, Stites T1, Li B, Cappiello L, von Rosenstiel P, Lublin FD. Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2014; 13(6): 545-556. Go to original source... Go to PubMed...
    2. Correale J, Ysrraelit MC, Fiol MP. Benign multiple sclerosis: does it exist? Curr Neurol Neurosci Rep. 2012; 12(5): 601-609. Go to original source... Go to PubMed...
    3. Havrdova E, Zivadinov R, Krasensky J, Dwyer MG, Novakova I, Dolezal O, Ticha V, Dusek L, Houzvickova E, Cox JL, Bergsland N, Hussein S, Svobodnik A, Seidl Z, Vaneckova M, Horakova D. Randomized study of interferon beta-1a, low-dose azathioprine, and low-dose corticosteroids in multiple sclerosis. Mult Scler. 2009; 15(8): 965-976. Go to original source... Go to PubMed...
    4. Havrdová E, Piťha J. Klinický standard pro diagnostiku a léčbu roztroušené sklerózy a neromyelitis optica 2012, dostupné z url: http://www.imuno.neurologiefnhk.cz/doc/Dx_Tx_RSaNMO-standard.pdf.
    5. Fazekas F, Berger T, Fabjan TH, Ledinek AH, Jakab G, Komoly S, Kraus J, Kurča E, Kyriakides T, Lisý L, Milanov I, Panayiotou P, Jazbec SS, Taláb R, Traykov L, Turčáni P, Vass K, Vella N, Havrdová E. Fingolimod in the treatment algorithm of relapsing remitting multiple sclerosis: a statement of the Central and East European (CEE) MS Expert Group. Wien Med Wochenschr. 2012; 162(15-16): 354-366. Go to original source... Go to PubMed...
    6. Hansen T, Skytthe A, Stenager E, Petersen HC, Br?nnum-Hansen H, Kyvik KO. Concordance for multiple sclerosis in Danish twins: an update of a nationwide study. Mult Scler 2005; 11: 504-505. Go to original source... Go to PubMed...
    7. Hartung HP, Polman C, Bertolotto A, Deisenhammer F, Giovannoni G, Havrdova E, Hemmer B, Hillert J, Kappos L, Kieseier B, Killestein J, Malcus C, Comabella M, Pachner A, Schellekens H, Sellebjerg F, Selmaj K, Sorensen PS. Neutralising antibodies to interferon beta in multiple sclerosis: expert panel report. J Neurol. 2007; 254(7): 827-837. Go to original source... Go to PubMed...
    8. Hoepner R, Faissner S, Salmen A, Gold R, Chan A. Efficacy and side effects of natalizumab therapy in patients with multiple sclerosis. J Cent Nerv Syst Dis. 2014; 6: 41-49. Go to original source... Go to PubMed...
    9. Kappos L, Radue EW, O'Connor P, Polman C, Hohlfeld R, Calabresi P, Selmaj K, Agoropoulou C, Leyk M, Zhang-Auberson L, et al. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med. 2010 Feb 4; 362 (5): 387-401. Go to original source... Go to PubMed...
    10. Cohen JA, Barkhof F, Comi G, Hartung HP, Khatri BO, Montalban X, Pelletier J, Capra R, Gallo P, Izquierdo G, et al. Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med. 2010; 362(5): 402-415. Go to original source... Go to PubMed...
    11. Krasulová E, Havrdová E. Současná léčba relaps remitentní roztroušené sklerózy a perspektivy do budoucna. Klin Farmakol Farm 2008; 22(1): 23-29.
    12. Leray E, Coustans M, Le Page E, Yaouanq J, Oger J, Edan G., Clinically definite benign multiple sclerosis', an unwarranted conceptual hodgepodge: evidence from a 30-year observational study. Mult Scler. 2013; 19(4): 458-456. Go to original source... Go to PubMed...
    13. Mandia D, Ferraro OE, Nosari G, Montomoli C, Zardini E, Bergamaschi R. Environmental factors and multiple sclerosis severity: a descriptive study. Int J Environ Res Public Health. 2014; 11(6): 6417-6432. Go to original source... Go to PubMed...
    14. Meluzínová E, Libertinová J, Zajac M, Maťoška V. Sledování biologické účinnosti interferonu beta při léčbě pacientů s roztroušenou sklerózou v České republice. Neurol. praxi 2013; 14(5): 258-226.
    15. Polman CH, Bertolotto A, Deisenhammer F. Recommendations for clinical use of data on neutralising antibodies to interferon-beta therapy in multiple sclerosis Lancet Neurol. 2010; 9(7): 740-750. Go to original source... Go to PubMed...
    16. Sadovnick AD, Ebers GC, Dyment DA, Risch NJ. Evidence for genetic basis of multiple sclerosis. The Canadian Collaborative Study Group. Lancet 1996; 347: 1728-1730. Go to original source... Go to PubMed...
    17. Westerlind H, Ramanujam R, Uvehag D, Kuja-Halkola R, Boman M, Bottai M, Lichtenstein P, Hillert J. Modest familial risks for multiple sclerosis: a registry-based study of the population of Sweden. Brain. 2014; 137(3): 770-778. Go to original source... Go to PubMed...
    18. Wingerchuk DM, Carter JL. Multiple sclerosis: current and emerging disease-modifying therapies and treatment strategies. Mayo Clin Proc. 2014; 89(2): 225-240. Go to original source... Go to PubMed...

    Return to the content


    Neurology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.