Fingolimod
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Rebound effect in the form of flare-up of multiple sclerosis: case report A 66-year-old woman developed rebound effect in the form of flare-up of multiple sclerosis (MS) during treatment with fingolimod for MS. The woman, who was monitored from 1995 for MS, had been receiving treatment with fingolimod [route and dosage not stated] since 2013 due to continuation of clinical flare-ups despite of slow worsening of disability since previous 1 year. The progression to a secondary-progressive form without clinical flare-up or radiologic activity resulted in the discontinuation of fingolimod in November 2018. After three months, rapidly progressive clinical worsening with appearance of deficit in the upper extremities and inability to make transfers alone was observed. The cerebral MRI shows a dozen-some lesions in the supratentorial and infratentorial regions highlighted by contrast product and the CSF study found a lymphocytic meningitis with CSF protein level of 0.8 g/dL, aseptic. Due to the normality of systemic etiological assessment, brain biopsy highlighting multiple florid inflammatory and demyelinating lesions, the diagnosis of severe flare-up of MS after discontinuation of fingolimod was confirmed, which was considered as rebound effect. The woman was treated with methylprednisolone sodium succinate [solumedrol] and ocrelizumab which led to stabilisation of symptoms. Scuccimarra M, et al. Rebound effect after discontinuation of fingolimod in the secondary-progressive form of multiple sclerosis Revue Neurologique 176 (Suppl.): S127, Sep 803505620 2020. Available from: URL: http://doi.org/10.1016/j.neurol.2020.01.348 [abstract] [French; summarised from translation]
0114-9954/20/1825-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 10 Oct 2020 No. 1825
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