title: Fingolimod for multiple sclerosis: mechanism of action, clinical outcomes, and future directions.
abstract: The oral sphingosine 1-phosphate receptor (S1PR) modulator fingolimod functionally antagonizes S1PR hereby blocking lymphocyte egress from secondary lymphoid organs to the peripheral blood circulation. This results in a reduction in peripheral lymphocyte counts, including potentially encephalitogenic T cells. In patients with relapsing multiple sclerosis fingolimod has been shown to be an effective treatment. In phase 2 and phase 3 studies fingolimod-treated patients had reduced disease activity clinically and in MRI. Although severe infectious complications occurred in single cases treated with fingolimod, the frequency of overall infections was comparable in fingolimod-treated patients and controls. Overall, in clinical studies fingolimod was well tolerated and had a favorable safety profile. In follow-up studies with continuous fingolimod, treatment showed sustained efficacy while being well tolerated.
authors.affiliation: Department of Neurology and Department of Biomedicine, University Hospital Basel, Petersgraben, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Mehling
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.forename: Tobias
authors.initials: T
authors.lastname: Derfuss
mesh_terms: D002490:Central Nervous System / Q000187:drug effects / Q000276:immunology; D002986:Clinical Trials as Topic; D000068876:Fingolimod Hydrochloride; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000473:pathology; D011409:Propylene Glycols / Q000627:therapeutic use*; D013110:Sphingosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D000068876:Fingolimod Hydrochloride; D013110:Sphingosine