A fingolimod cardiovascularis hatásának klinikai jelentősége a sclerosis multiplex kezelésében

Translated title of the contribution: Clinical significance of the cardiovascular effects of fingolimod treatment in multiple sclerosis

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Fingolimod is a sphingosine-1 phosphate receptor modulator, which is effective in the treatment of severe relapsing-remitting form of multiple sclerosis. Once daily oral use of fingolimod decreased the annualized relapse rate, inflammatory brain lesion activity and the rate of brain atrophy compared both to placebo and intramuscular administered interferon beta-1a. The drug targets the cardiovascular system as well via sphingosine-1 phosphate receptors. After initiation of fingolimod therapy transient sinus bradycardia and slowing of the atrioventricular conduction develops. The onset of the effect is as early as 1 hour post administration, while heart rate and conduction normalized in 24 hours in most of the cases. According to the clinical trials symptomatic bradycardia developed in 0.5% of the cases, responding to the appropriate therapy. The incidence of Mobitz I type II atrioventricular blocks and blocks with 2:1 atrioventricular conduction was 0.2% and 0.1%, respectively. All of these cardiovascular events showed regression during observation and no higher degree atrioventricular blocks were detected at the approved therapeutic dose. Following the first dose effect, fingolimod had a moderate hypertensive effect on long-term. For the safety of fingolimod treatment detailed cardiovascular risk stratification of all patients, adequate patient monitoring after the first dose and competency in treating the possible side effects is necessary. In patients with increased cardiovascular risks, treatment should be considered only if anticipated benefits outweigh potential risks and extended monitoring is required.

Translated title of the contributionClinical significance of the cardiovascular effects of fingolimod treatment in multiple sclerosis
Original languageHungarian
Pages (from-to)369-376
Number of pages8
JournalIdeggyogyaszati szemle
Volume65
Issue number11-12
Publication statusPublished - Nov 30 2012

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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