Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy.
Eur J Neurol. 2018 Oct;25(10):1270-1275. doi: 10.1111/ene.13694. Epub 2018 Jul 10.
There is debate as to whether the apparent rebound after fingolimod discontinuation is related to the discontinuation itself or whether it is due to the natural course of highly active multiple sclerosis (MS). Our aim was to survey the prevalence of severe reactivation and rebound after discontinuation of fingolimod in a cohort of Italian patients with MS.
Patients with relapsing-remitting MS who were treated with fingolimod for at least 6 months and who stopped treatment for reasons that were unrelated to inefficacy were included in the analysis.
A total of 100 patients who had discontinued fingolimod were included in the study. Fourteen patients (14%) had a relapse within 3 months after fingolimod discontinuation, and an additional 12 (12%) had a relapse within 6 months. According to this study's criteria, 10 patients (10%) had a severe reactivation. Amongst these patients, five (5%) had a reactivation that was considered to be a rebound.
The present study showed that more than 26% of patients are at risk of having a relapse within 6 months after fingolimod discontinuation. Nevertheless, the risk of severe reactivations and rebound is lower than has been previously described.
停药后出现的明显反弹现象是与停药本身有关，还是与高度活跃的多发性硬化症（MS）的自然病程有关，目前仍存在争议。我们的目的是在意大利 MS 患者队列中调查停用芬戈莫德后严重复发和反弹的发生率。
纳入分析的患者为接受芬戈莫德治疗至少 6 个月且因与疗效无关的原因停药的复发性缓解型 MS 患者。
共有 100 名停用芬戈莫德的患者纳入本研究。14 名患者（14%）在停药后 3 个月内复发，另外 12 名患者（12%）在停药后 6 个月内复发。根据本研究的标准，10 名患者（10%）发生严重再激活。在这些患者中，有 5 名（5%）出现了反弹现象。
本研究表明，超过 26%的患者在停用芬戈莫德后 6 个月内有复发的风险。然而，严重再激活和反弹的风险低于之前的描述。
