One-year Effectiveness and Side Effects of Fingolimod in Multiple Sclerosis Patients

 Background and purpose: Fingolimod, is one of the first oral disease-modifying treatments (DMT) that has shown efficacy in advanced clinical trials for the treatment of multiple sclerosis (MS). The present study examined the one-year effectiveness and side effects of fingolimod. Materials and methods: In this quasi-experimental study, 26 MS patients attending Kermanshah Imam Reza Hospital were treated with fingolimod for one year (2018-19). Before and after treatment, the severity of disability (EDSS score), frequency of active lesions on MRI, and incidence of drug-related complications were studied. Data were analyzed using SPSS V25. Results: The mean age of patients was 34.23 ± 6.9 (17-44 years old), including 20 (76.9%) females and 6 (23.1%) males. The average duration of disease was 7.63±4.7 years. Relapsing-remitting multiple sclerosis (RRMS) and relapsing progressive (PRMS) were observed in 23 (88.5%) and 3 (11.5%) patients, respectively. The EDSS score was significantly lower at the end of the study (2.29±2.0) than the beginning of the study (3.12±1.9) (P= 0.001). The frequency of cases with active lesions in MRI was 63.6% before the treatment that decreased to 40.0% after treatment (P>0.05). No immediate side effects were reported, but delayed complications occurred in 27% of RRMS patients, including hair loss (n=1), increased liver enzyme levels (n=3), cardiac complications (n=2), and depression (n=1). PRMS patients had no delayed complications. Conclusion: Fingolimod has a good effect in RRMS and PRMS patients with tolerable side effects.