Abstract| Volume 37, 101582, January 2020

1-Year Follow Up Efficacy of Fingolimod in the Treatment of Relapsing-Remitting Multiple Sclerosis (RR-MS) Among Saudi Patients

      Fingolimod is a sphingosine 1-phosphate (S1P) receptor modulator and was the first oral therapy to be approved for multiple sclerosis (MS), receiving a broad first-line indication for relapsing-remitting forms of MS (RR-MS) in the United States of America (USA) in 2010. Fingolimod has shown a significant effect on clinical and magnetic resonance imaging outcome. The aim of this study is to assess the clinical and radiological efficacy of 1 year of Fingolimoid in patients with RR-MS.
      A retrospective study of Saudi patients diagnosed with relapsing RR-MS and managed with Fingolimod at Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia, between 2014 and 2016. MS diagnosis was confirmed based on clinical relapses and T1 and T2 magnetic resonance imaging (MRI) findings consistent with Mcdonald criteria. Clinical characteristics including total number of relapses, Expanded Disability Status Scale (EDDS), along MRI findings outcomes were retrieved from medical records of compliant patients who has at least a 1- year follow up.
      Between January 2014 and December 2016, 20 patients (15 women) were prescribed fingolimod 0.5 mg daily, either as first-line or escalation therapy. All patients were complaint to the treatment for at-least 1 year follow up. Mean age was 32.25+/-11.02. Furthermore, 19 patients had relapsing-remitting multiple sclerosis. The annual relapse rate (ARR) was 0 in 18 patients along with n EDSS of 0 in 15 patients. Moreover, there was significant reduction of gadolinium enhancement lesion on MRI in 17 patients and no new lesions in all. 85% of the fingolimod-treated petients achieved no evidence of disease activity (NEDA-3).
      Fingolimod showed high efficacy in the stabilization of relapsing-remitting multiple sclerosis among Saudi patients following 1 year of treatment. This was reflected in terms of clinical and radiological findings. Fingolimod robust effect on NEDA-3 was quite clear.