What is it about?
This article highlights the conundrum of using Gilenya (Fingolimod) in RRMS patients, or patients with relapsing forms of MS. Absolute lymphocyte counts can drop perilously low AND for prolonged periods with Gilenya use; however, if the drug is stopped because of this issue and concern for secondary infections, REBOUND phenomena can crop up, including tumefactive -type lesions. So it is a case of damned if you do, damned if you don't. The FDA and 'thought leaders' need to step in and direct the MS community on ways to address this carefully because the next big disaster might be lurking just past the next turn !!
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Why is it important?
As noted above, this impacts patient safety and that has to be issue #1 for any clinician treating MS with Gilenya.
Perspectives
The above perspectives are mine. My co-authors have no comments. As noted above, we put up this article to highlight the importance of how to address patient safety concerns or questions that can crop up with the use of Gilenya.
Dr Jagannadha R Avasarala
Greenville Memorial Hospital
Read the Original
This page is a summary of: Approach to Fingolimod-Induced Lymphopenia in Multiple Sclerosis Patients: Do We Have a Roadmap?, The Journal of Clinical Pharmacology, May 2017, Wiley,
DOI: 10.1002/jcph.945.
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