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复发缓解型多发性硬化症患者中芬戈莫德的心血管副作用爆发:一项伊朗人群的纵向研究。

The outbreak fingolimod cardiovascular side effects in relapsing-remitting multiple sclerosis patient: A longitudinal study in an Iranian population.

作者信息

Abdar Morteza, Ebrahimifar Payam, Etemadifar Masoud

机构信息

Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

ARYA Atheroscler. 2016 Nov;12(6):274-280.

Abstract

BACKGROUND

Fingolimod (FTY-720) has shown efficacy in relapsing multiple sclerosis (MS), while some side effects of this drug have been recognized that the most important is cardiovascular side effects. The aim of this study was to evaluate the cardiovascular side effects of FTY-720. However, the effect of fingolimod on cardiac has not been well recognized. This study was designed to evaluate the cardiovascular side effects of fingolimod in relapsing-remitting multiple sclerosis (RRMS) patient in an Iranian population.

METHODS

This prospective clinical trial study was performed on 200 RRMS patients. The patients received a single daily oral dose of fingolimod 0.5 mg. During the first 6 hours after the first fingolimod dose, the patients' vital signs and electrocardiographic traces were continuously monitored. Moreover, the patients followed up over 6 months after receiving fingolimod.

RESULTS

The results showed that pulse rate (P < 0.001), systolic blood pressure (BP) (P < 0.001), and diastolic BP (P < 0.001) were decreased significantly during 6 hours after receiving the first dose of fingolimod. The most reduction in vital sign was observed in 3 hours. Arrhythmia, bradycardia, and dizziness were the other complications of fingolimod, which were detected in our study.

CONCLUSION

All the side effects such as hypotension and bradycardia were happened in first 3 hours after receiving the fingolimod. Indeed, we advise clinicians to monitor the patients for first 6 hours after initiation of fingolimod to decrease worse side effects.

摘要

背景

芬戈莫德(FTY - 720)已在复发型多发性硬化症(MS)中显示出疗效,同时该药物的一些副作用已被认识到,其中最重要的是心血管副作用。本研究的目的是评估芬戈莫德的心血管副作用。然而,芬戈莫德对心脏的影响尚未得到充分认识。本研究旨在评估芬戈莫德在伊朗人群复发缓解型多发性硬化症(RRMS)患者中的心血管副作用。

方法

这项前瞻性临床试验研究对200例RRMS患者进行。患者每日口服一次芬戈莫德0.5毫克。在首次服用芬戈莫德后的前6小时内,持续监测患者的生命体征和心电图。此外,患者在接受芬戈莫德治疗后随访6个月。

结果

结果显示,在首次服用芬戈莫德后的6小时内,脉搏率(P < 0.001)、收缩压(BP)(P < 0.001)和舒张压(P < 0.001)均显著下降。在3小时时观察到生命体征下降最为明显。心律失常、心动过缓和头晕是芬戈莫德的其他并发症,在我们的研究中被检测到。

结论

所有副作用如低血压和心动过缓均发生在服用芬戈莫德后的前3小时内。实际上,我们建议临床医生在开始使用芬戈莫德后的前6小时内对患者进行监测,以减少更严重的副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e388/5455326/5582cccb1bd5/ARYA-12-274f1.jpg

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