Fragoso Yara Dadalti
Department of Neurology, Medical School, UNIMES, Universidade Metropolitana de Santos, Avenida Conselheiro Nebias 536, Santos, SP, CEP 11045-002, Brazil.
Acta Neurol Belg. 2017 Dec;117(4):821-827. doi: 10.1007/s13760-017-0794-7. Epub 2017 May 20.
Fingolimod was the first oral medication approved for management of multiple sclerosis and is currently used by tens of thousands patients worldwide. Fingolimod acts via the sphingosine 1-phosphate (S1P) receptor, maintaining peripheral lymphocytes entrapped in the lymph nodes. In consequence, there is a reduction in the infiltration of aggressive lymphocytes into the central nervous system. The drug is safe and effective, and its first hours of use are associated with related to S1P receptors in the heart. This side effect is well known by all doctors prescribing fingolimod. However, the drug has other potential adverse events that, although relatively rare, require awareness from the neurologist. Among these there are infections (herpes simplex, herpes zoster, Cryptococcus, Epstein-Barr virus, hepatitis, Molluscum Contagiosum, and leishmaniosis), lung and thyroid complications, refractory headaches, encephalopathy, vasculopathy, tumefactive lesions in magnetic resonance imaging and ophthalmological disorders. The present review lists the non-cardiologic adverse events that all neurologists prescribing fingolimod should be aware of.
芬戈莫德是首个被批准用于治疗多发性硬化症的口服药物，目前全球有数万名患者使用。芬戈莫德通过鞘氨醇-1-磷酸（S1P）受体发挥作用，使外周淋巴细胞滞留在淋巴结中。因此，侵袭性淋巴细胞向中枢神经系统的浸润减少。该药物安全有效，其使用的最初几个小时与心脏中的S1P受体有关。所有开具芬戈莫德处方的医生都熟知这种副作用。然而，该药物还有其他潜在不良事件，尽管相对罕见，但神经科医生仍需了解。其中包括感染（单纯疱疹、带状疱疹、隐球菌、爱泼斯坦-巴尔病毒、肝炎、传染性软疣和利什曼病）、肺部和甲状腺并发症、难治性头痛、脑病、血管病变、磁共振成像中的肿块性病变以及眼科疾病。本综述列出了所有开具芬戈莫德处方的神经科医生应了解的非心脏不良事件。
