Highlights
- •Rebound occurs in about 10% of MS patients who discontinued fingolimod.
- •Rebound was more common in younger patients.
- •Long washout period after discontinuation of fingolimod may increase the likelihood of rebound.
Abstract
Background It is still controversial whether the relapse experienced after discontinuation of
fingolimod treatment is a rebound. Increasing cases of rebound have been reported
in the literature. The rate of fingolimod rebound in patients after fingolimod cessation
is reported between 5% and 52%. The present study aims to determine the rate of rebound
after discontinuation of fingolimod treatment and the factors affecting the rebound.
Methods This retrospective cohort study consists of adult MS patients who have been admitted
to the Hacettepe University Hospital Neurology MS Center outpatient clinic between
2012 and 2020.
Results During the study period, 642 patients received fingolimod and 23.1% discontinued
the fingolimod treatment. Thirteen of 126 patients had a rebound (10.3%) after fingolimod
discontinuation. The patients in the rebound group were significantly younger and
washout period were significantly longer than those in the non-rebound group. After
discontinuation of fingolimod treatment, the EDSS score of the rebound group was significantly
higher than the non-rebound group, while Annualized Relapse Rates were similar.
Conclusion Younger age, longer washout time, and previous treatment preferences may increase
the occurrence probability of rebound. It is recommended that patients should be closely
monitored after fingolimod discontinuation and appropriate disease-modifying therapy
should be initiated as soon as possible.
Keywords
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Article info
Publication history
Published online: September 26, 2021
Accepted:
September 23,
2021
Received in revised form:
September 6,
2021
Received:
June 28,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
