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Case report| Volume 2, ISSUE 3, P252-255, July 2013

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Rebound exacerbation multiple sclerosis following cessation of oral treatment

  • Roy G. Beran
    Correspondence
    Corresponding author at:Strategic Health Evaluators, PO Box 598, Northbridge, 1560 NSW, Australia. Tel.: +61 2 9828 3646; fax: +61 2 9828 3648.
    Affiliations
    Department of Neurology, Liverpool Hospital and The South Western Sydney Clinical School, University of New South Wales, New South Wales (NSW), Australia

    School of Medicine, Griffith University, Queensland, Australia

    Strategic Health Evaluators, PO Box 598, Northbridge, 1560 NSW, Australia
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  • Yaser Hegazi
    Affiliations
    Department of Neurology, Liverpool Hospital and The South Western Sydney Clinical School, University of New South Wales, New South Wales (NSW), Australia
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  • Raymond S. Schwartz
    Affiliations
    Southern Neurology, 2/19 Kensington Street, Kogarah, NSW, Australia
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  • Dennis J. Cordato
    Affiliations
    Department of Neurology, Liverpool Hospital and The South Western Sydney Clinical School, University of New South Wales, New South Wales (NSW), Australia

    Southern Neurology, 2/19 Kensington Street, Kogarah, NSW, Australia
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Published:December 26, 2012DOI:https://doi.org/10.1016/j.msard.2012.11.001
Rebound exacerbation multiple sclerosis following cessation of oral treatment
Previous ArticleTo tell or not to tell? Revealing the diagnosis in multiple sclerosis
Next ArticleSevere early bilateral macular edema following fingolimod therapy

      Abstract

      Background

      Multiple sclerosis (MS) management is changing, revolutionized by oral agents. Immune Reconstitution Inflammatory Syndrome (IRIS) describes exaggerated response to both exogenous (infective) and endogenous (non-infective) antigens.

      Methods

      This paper reports two cases of MS “rebound” following withdrawal of oral treatments.

      Results

      Two patients, with suboptimal response to interferons, trialled oral MS treatment (fingolimod and BG12) with excellent response. Upon cessation both experienced MS “rebound” which responded to steroids.

      Conclusions

      “Rebound” may occur following withdrawal of oral MS therapies. Patients should be advised accordingly and possibly started on alternative treatment before the immunomodulating effect of therapy has subsided.

      Keywords

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      References

        • Kappos L
        • Radue EW
        • O’Connor P
        • et al.
        A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis.
        New England Journal of Medicine. 2010; 362: 387-401
        View in Article
        • Linker RA
        • Lee DH
        • Ryan S
        • et al.
        Fumaric acid esters exert neuroprotective effects in neuroinflammation via activation of the Nrf2 antioxidant pathway.
        Brain. 2011; 134: 678-692
        View in Article
        • Mehling M
        • Johnson TA
        • Antel J
        • Kappos L
        • Bar-Or A.
        Clinical immunology of the sphingosine 1-phosphate receptor modulator fingolimod (FTY720) in multiple sclerosis.
        Neurology. 2011; 76: S20-S27
        View in Article
        • O’Connor PW
        • Goodman A
        • Kappos L
        • et al.
        Disease activity return during natalizumab treatment interruption in patients with multiple sclerosis.
        Neurology. 2011; 76: 1858-1865
        View in Article
        • Miravalle A
        • Jensen R
        • Kinkel P.
        Immune reconstitution inflammatory syndrome in patients with multiple sclerosis following cessation of natalizumab therapy.
        Archives of Neurology. 2011; 68: 186-191
        View in Article
        • Wenning W
        • Haghikia A
        • Laubenberger J
        • et al.
        Treatment of progressive multifocal leukoencephalopathy associated with natalizumab.
        New England Journal of Medicine. 2009; 361: 1075-1080
        View in Article

      Article info

      Publication history

      Published online: December 26, 2012
      Accepted: November 12, 2012
      Received in revised form: October 4, 2012
      Received: June 13, 2012

      Identification

      DOI: https://doi.org/10.1016/j.msard.2012.11.001

      Copyright

      © 2013 Published by Elsevier Inc.

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