Fingolimod: efectividad y seguridad en la práctica clínica habitual. Estudio observacional, retrospectivo y multicéntrico en Galicia

Abstract

Introduction. The effectiveness and safety of fingolimod in patients with relapsing-remitting multiple sclerosis (RRMS) have been proven in clinical trials. Yet,due to their limitations,it is important to know how it behaves under everyday clinical practice conditions. Hence,the aim of this study is to evaluate the effectiveness and safety of fingolimod after 12 months’ usage in clinical practice in Galicia. Patients and methods. We conducted a retrospective,multi-centre study (n = 8) of patients with RRMS who were treated with one or more doses of fingolimod,0.5 mg/day. Effectiveness was assessed -annualised relapse rate (ARR),changes in the score on the Expanded Disability Status Scale (EDSS),percentage of patients free from relapses,free from progression of disability and free from activity in resonance-for the total number of patients and according to previous treatment. Safety was assessed based on the percentage of patients who withdrew and presented adverse side effects. Results. After 12 months’ use,fingolimod reduced the ARR by 87% (1.7 to 0.23; p < 0.0001) and,consequently,81% of patients were free from relapses. The score was reduced by 9%. In all,91% of patients were free from progression of disability and 72% were free from resonance activity. No signs of disease activity were found in 43% of the patients. Most of the benefits of fingolimod differed depending on previous treatment. About a third of the patients reported adverse side effects,but only 2% of them withdrew for this reason. Conclusions. In clinical practice,most of the results on the effectiveness of the clinical trials conducted with fingolimod were observed during the first 12 months of treatment. A better safety profile was observed than that reported in the clinical trials.