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Oral Fingolimod or Intramuscular Interferon for Relapsing Multiple Sclerosis
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Journal Article
Oral Fingolimod or Intramuscular Interferon for Relapsing Multiple Sclerosis
2010
Overview
In this 12-month trial involving patients with relapsing–remitting multiple sclerosis, oral fingolimod was more effective than intramuscular interferon beta-1a in reducing relapse rates. Adverse events associated with fingolimod included herpesvirus infections (two fatal infections), atrioventricular block, macular edema, skin cancer, and liver-enzyme elevation.
In patients with relapsing–remitting multiple sclerosis, oral fingolimod was more effective than intramuscular interferon beta-1a in reducing relapse rates. Adverse events included herpesvirus infections (two fatal infections), atrioventricular block, macular edema, skin cancer, and liver-enzyme elevation.
Oral fingolimod (FTY720) is a sphingosine-1-phosphate–receptor modulator. After phosphorylation, fingolimod acts as a functional antagonist of the sphingosine-1-phosphate type 1 receptor, inducing receptor internalization and rendering T and B cells insensitive to a signal necessary for egress from secondary lymphoid tissues.
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The resulting redistribution to lymph nodes reduces recirculation of autoaggressive lymphocytes to the central nervous system.
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Also, fingolimod is lipophilic, readily crosses the blood–brain barrier, and is phosphorylated within the central nervous system.
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Through interaction with sphingosine-1-phosphate receptors on neural cells, fingolimod may have neuroprotective or reparative effects.
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Fingolimod effectively treats experimental autoimmune encephalomyelitis, an animal . . .
Publisher
Massachusetts Medical Society
Subject
/ Adult
/ Arrhythmias, Cardiac - chemically induced
/ Biological and medical sciences
/ Female
/ Humans
/ Immunosuppressive Agents - adverse effects
/ Immunosuppressive Agents - therapeutic use
/ Interferon-beta - adverse effects
/ Interferon-beta - therapeutic use
/ Male
/ Multiple Sclerosis, Relapsing-Remitting - drug therapy
/ Multiple Sclerosis, Relapsing-Remitting - pathology
/ NMR
/ Propylene Glycols - adverse effects
/ Propylene Glycols - therapeutic use
/ Sphingosine - adverse effects
/ Sphingosine - analogs & derivatives
