Fingolimod for Relapsing-Remitting Multiple Sclerosis: The Experience from Saudi Arabia

Abstract

Fingolimod (Gilenya, Novartis pharmaceuticals) is the first oral disease-modifying therapy for reducing the frequency of clinical relapses and delaying disability progression in patients diagnosed with relapsing-remitting multiple sclerosis (RRMS). In this study, we aim to evaluate the outcome of Saudi patients with active RRMS treated with fingolimod and compare the result with other studies. We conducted a retrospective multicenter observational study involving 100 patients with RRMS at King Abdulaziz Medical City in Jeddah and Riyadh, Saudi Arabia. The inclusion criteria consisted of patients above the age of 18 years, diagnosed with RRMS according to the revised McDonald criteria, and are currently receiving or received fingolimod treatment in the past for a minimum of six months. The mean baseline expanded disability status scale (EDSS) score was 2.95±2.58 (range 1-7; median 1.75). The mean EDSS score at last follow up was 2.95±2.65 (range 1-10; median 2.00). The mean annualized relapse rate (ARR) was significantly reduced from 1.24±1.39 at baseline to 0.43±1.15 at the last follow-up (P = 0.001). In addition, radiological activity was significantly improved at follow-up magnetic resonance imaging (MRI) studies when compared to the baseline. Our multi-center study provides further evidence on the efficacy of fingolimod in reducing clinical and radiological disease activity in patients with RRMS. The reduction in relapse rate, stabilization of EDSS score, and improvement in MRI images were similar to other observational studies conducted in different countries worldwide. Fingolimod appears to be a well-tolerated for our MS population.