Skip to main content

Advertisement

SpringerLink
Log in

Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

We report two cases of primary progressive multiple sclerosis (PPMS) included in the INFORMS cohort, experiencing a relapse related to a single MRI gadolinium-enhancing lesion 3 months after fingolimod withdrawal. These two patients share similarities with relapsing-remitting multiple sclerosis cases described in the same situation, suggesting that the initiating process of the active demyelinating plaques is also present in PPMS, even without relapses, but may be triggered as fingolimod is withdrawn. Although the results of the INFORMS study suggest that fingolimod may not slow down the progression, some PPMS patients might still benefit from a disease-modifying treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 46(4):907–911

    Article  CAS  PubMed  Google Scholar 

  2. Lublin F, Miller DH, Freedman MS, Cree BAC, Wolinsky JS, Weiner H, Lubetzki C, Hartung H-P, Montalban X, Uitdehaag BMJ, Merschhemke M, Li B, Putzki N, Liu FC, Häring DA, Kappos L, INFORMS Study Investigators (2016) Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Lond Engl 387:1075–1084

    Article  CAS  Google Scholar 

  3. Havla JB, Pellkofer HL, Meinl I, Gerdes LA, Hohlfeld R, Kümpfel T (2012) Rebound of disease activity after withdrawal of fingolimod (FTY720) treatment. Arch Neurol 69(2):262–264

    Article  PubMed  Google Scholar 

  4. Ghezzi A, Rocca MA, Baroncini D, Annovazzi P, Zaffaroni M, Minonzio G, Comi G, Filippi M (2013) Disease reactivation after fingolimod discontinuation in two multiple sclerosis patients. J Neurol 260(1):327–329

    Article  CAS  PubMed  Google Scholar 

  5. Berger B, Baumgartner A, Rauer S, Mader I, Luetzen N, Farenkopf U, Stich O (2015) Severe disease reactivation in four patients with relapsing-remitting multiple sclerosis after fingolimod cessation. J Neuroimmunol 282:118–122

    Article  CAS  PubMed  Google Scholar 

  6. Hakiki B, Portaccio E, Giannini M, Razzolini L, Pastò L, Amato MP (2012) Withdrawal of fingolimod treatment for relapsing-remitting multiple sclerosis: report of six cases. Mult Scler Houndmills Basingstoke Engl 18(11):1636–1639

    Article  Google Scholar 

  7. Confavreux C, Vukusic S (2006) Natural history of multiple sclerosis: a unifying concept. Brain J Neurol 129(Pt 3):606–616

    Article  Google Scholar 

  8. Antel J, Antel S, Caramanos Z, Arnold DL, Kuhlmann T (2012) Primary progressive multiple sclerosis: part of the MS disease spectrum or separate disease entity? Acta Neuropathol (Berl.) 123(5):627–638

    Article  Google Scholar 

  9. Jacques FH (2015) Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology 84(9):963

    Article  PubMed  Google Scholar 

  10. Hawker K, O’Connor P, Freedman MS, Calabresi PA, Antel J, Simon J, Hauser S, Waubant E, Vollmer T, Panitch H, Zhang J, Chin P, Smith CH, OLYMPUS Trial Group (2009) Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial. Ann Neurol 66(4):460–471

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France

    Jean-Baptiste Davion, M. Cambron, E. Duhin, A. Chouraki, A. Lacour & P. Vermersch

  2. Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium

    M. Cambron

  3. Department of Neurology, University of Montpellier, Montpellier, France

    P. Labauge, C. Carra & X. Ayrignac

Authors
  1. Jean-Baptiste Davion
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Cambron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Duhin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Chouraki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Lacour
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Labauge
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. Carra
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. X. Ayrignac
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P. Vermersch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Baptiste Davion.

Ethics declarations

Conflicts of interest

Pr. Vermersch received honoraria and consulting fees from Biogen, Teva, Genzyme-Sanofi, Merck, Roche, Almirall, Novartis and research supports from Merck, Bayer and Biogen. Dr. Labauge received financial contribution from Novartis and BiogenIdec for travel, honoraria for speaking from Genzyme. Dr. Cambron received consulting fees from Novartis, Genzyme-Sanofi and Teva as well as financial contribution for travel from Novartis, Genzyme-Sanofi, Biogen, Teva, Merck and Bayer. Dr. Duhin received financial contribution from Genzyme and Biogen for travel. Dr. Ayrignac, Carra and Davion have no disclosures.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Davion, JB., Cambron, M., Duhin, E. et al. Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal. J Neurol 263, 1361–1363 (2016). https://doi.org/10.1007/s00415-016-8144-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-016-8144-x

Keywords

Search

Navigation