Ventricular arrhythmia in a male MS patient on fingolimod
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Fingolimod is a structural analogue of sphingosine-1-phosphate approved as the first oral agent for the treatment of relapsing remitting multiple sclerosis. Apart from its effects on the immune system, fingolimod is known to have a negative chronotropic effect upon first dose intake. Little is known, however, about the longer term potential effects of fingolimod on ventricular rhythm. We document an increase in ventricular premature complexes (VPCs) in a patient on fingolimod who experienced three unexplained syncopes while on treatment. VPC frequency decreased significantly and no further syncopes occurred after stopping fingolimod. This suggests that, in predisposed patients, fingolimod might potentiate the occurrence of ventricular arrhythmia.
KeywordsMultiple Sclerosis Fingolimod Cardiac arrhythmia Safety
Conflicts of interest
V. van Pesch has received travel grants and honoraria for consultancy and lectures from from Biogen Idec, Bayer Schering, Sanofi Aventis, Genzyme, Merck Serono and Novartis Pharma. C. Sindic has received honoraria for consultancy and lectures, and educational and research grants, from Bayer-Schering, Biogen Idec, GSK Biological Vaccines, Merck Serono, Novartis, Sanofi-Aventis and Teva. S. El Sankari has received consultancy fees from Biogen Idec and travel grants from Biogen Idec, Bayer Schering, Sanofi Aventis, Genzyme, Merck Serono and Novartis Pharma. S. Marchandise has nothing to disclose.
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