Fingolimod for the Treatment of Relapsing-Remitting Multiple Sclerosis/Relapsing Remitting Multipl Skleroz Tedavisinde Fingolimod Kullanimi

• Published in: Türk nöroloji dergisi Vol. 23; no. 4; p. 176
• Main Authors: Altunrende, Burcu, Birday, Erkingul, Kasap, Mithat, Demir, Gulsen Akman
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.12.2017
• Subjects: Analysis; Dosage and administration; Drug therapy; Fingolimod; Health aspects; Inflammation; Multiple sclerosis; Patient compliance; United States
• ISSN: 1301-062X; 1309-2545
• DOI: 10.4274/tnd.62144

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system and is characterized by inflammation, demyelination, and axonal loss. Fingolimod is the first oral drug for the treatment of MS approved by the United States Food and Drug Administration, European Union countries, and various other countries. The compound exerts its effect via interaction with lysophospholipid receptors known as sphingosine-1 phosphate receptors. Although fingolimod has a very convenient daily oral dosing, it may cause development of bradycardia at the first dose, macular edema, infection, all of which require attention. Randomized double-blind clinical trials have shown that fingolimod significantly reduces relapse rates and is beneficial in brain magnetic resonance imaging measures when compared with both placebo and intramuscular interferon [beta]-1a. This review describes the characteristics of fingolimod concerning its efficacy, safety, and tolerability in the clinical context of the management of MS. Keywords: Multiple sclerosis, fingolimod, sphingosine-1 phosphate, efficacy, safety Oz Multipl skleroz (MS) merkezi sinir sisteminin enflamasyon, demiyelinizasyon ve akson kaybi ile karakterize kronik otoimmun, norodejeneratif bir hastaligidir. Fingolimod Amerikan Ilac ve Gida Dairesi ve Avrupa Birligi uyesi ulkelerin de bulundugu 80'den fazla ulke tarafindan onaylanmis ilk oral MS ilacidir. Bu bilesik, sfingozin-1 fosfat olarak bilinen lizofosfolipid reseptorleri araciligi ile etkilerini gosterir. Gunluk oral yolla kullanimi kolaylik saglamakla birlikte bazi hastalarda ilk doz sirasinda bradikardi gelismesi, makuler odem, enfeksiyon gibi bazi dikkat edilmesi gereken durumlar ile karsilasilabilmektedir. Randomize cift-kor klinik calismalar, plasebo ve intramuskuler interferon [beta]-1a tedavilerine kiyasla fingolimodun atak sikligini anlamli derecede azalttigini ve beyin manyetik rezonans olcutleri uzerine yararli etkiler gosterdigini ortaya koymustur. Bu derlemede, fingolimodun klinikte MS hastalarinin yonetimindeki etkinligi, guvenliligi ve tolerabilitesi ele alinmistir. Anahtar Kelimeler: Multipl skleroz, fingolimod, sfingozin-1 fosfat, etkinlik, guvenlilik