REAL WORLD EXPERIENCE OF FINGOLIMOD IN MULTIPLE SCLEROSIS: THE LONDON AUDIT

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 87; no. 12; p. e1
• Main Authors: Stavrou, Maria, Smith, Deborah, Shaw, Pauline, Raciborska, Dominika, Silber, Eli, Brex, Peter, Giovannoni, Gavin, Schmierer, Klaus, Turner, Benjamin
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.12.2016
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp-2016-315106.160

BackgroundFingolimod is a licensed and NICE-approved disease modifying therapy (DMT) for people with relapsing multiple sclerosis (pwRMS).ObjectiveTo analyse the ‘real world’ experience of Fingolimod in two MS centres (Barts Health and King's College).MethodsPatients were identified through electronic medical records (March 2013–December 2015). Demographics, MS history and follow-up data were analysed.Results215 pwRMS were prescribed Fingolimod as second-line DMT in 77.6% (n=167) and first-line in 21% (n=45). 71.6% switched from Interferon-beta or Glatiramer acetate. Thirteen JCV positive pwRMS switched from Natalizumab to Fingolimod, due to risk of PML. Fingolimod was discontinued in 15% (n=32) due to adverse effects (most frequently headache, in one case infection), pregnancy and ongoing disease activity (n=10). The absolute lymphocyte count was <0.2 in 7 cases. 16.3% (n=35) had at least one relapse during the observation period, 46% of which had ongoing MRI activity.ConclusionsOur experience of Fingolimod as a treatment for pwRMS closely resembles the data from the original phase III clinical trials and supports the short-term safety and efficacy of Fingolimod in clinical practice. This collaboration between MS centres provides useful insights into the ‘real world’ experience of benefits and risks of DMTs for pwRMS.