title: The real-life experience with cardiovascular complications in the first dose of fingolimod for multiple sclerosis.
abstract: Fingolimod is a new and efficient treatment for multiple sclerosis (MS). The drug administration requires special attention to the first dose, since cardiovascular adverse events can be observed during the initial six hours of fingolimod ingestion. The present study consisted of a review of cardiovascular data on 180 patients with MS receiving the first dose of fingolimod. The rate of bradycardia in these patients was higher than that observed in clinical trials with very strict inclusion criteria for patients. There were less than 10% of cases requiring special attention, but no fatal cases. All but one patient continued the treatment after this initial dose. This is the first report on real-life administration of fingolimod to Brazilian patients with MS, and one of the few studies with these characteristics in the world.
authors.affiliation: Departamento de Neurologia, Universidade Metropolitana de Santos, Santos, SP, Brazil.
authors.forename: Yara Dadalti
authors.initials: YD
authors.lastname: Fragoso
authors.affiliation: Departamento de Neurologia, Universidade Positivo, Curitiba, PR, Brazil.
authors.forename: Christian Cardoso
authors.initials: CC
authors.lastname: Arruda
authors.affiliation: Departamento de Neurologia, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Walter Oleschko
authors.initials: WO
authors.lastname: Arruda
authors.affiliation: Departamento de Neurologia, Universidade Metropolitana de Santos, Santos, SP, Brazil.
authors.forename: Joseph Bruno Bidin
authors.initials: JB
authors.lastname: Brooks
authors.affiliation: Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Damasceno
authors.affiliation: Departamento de Neurologia, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Carlos Augusto de Albuquerque
authors.initials: CA
authors.lastname: Damasceno
authors.affiliation: Departamento de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Finkelsztejn
authors.affiliation: Departamento de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Finkelsztejn
authors.affiliation: Departamento de Neurologia, Pontifícia Universidade Católica Sorocaba, Sorocaba, SP, Brazil.
authors.forename: Paulo Diniz da
authors.initials: PD
authors.lastname: Gama
authors.affiliation: Clínica Holus MedService, Sao Paulo, SP, Brazil.
authors.forename: Maria Cristina Brandão
authors.initials: MC
authors.lastname: Giacomo
authors.affiliation: Departamento de Neurologia, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Sidney
authors.initials: S
authors.lastname: Gomes
authors.affiliation: Departamento de Neurologia, Centro Hospitalar Unimed, Joinville, SC, Brazil.
authors.forename: Marcus Vinicius Magno
authors.initials: MV
authors.lastname: Goncalves
authors.affiliation: Departamento de Neurologia, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Andre Palma da Cunha
authors.initials: AP
authors.lastname: Matta
authors.affiliation: Departamento de Neurologia, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Marilia Manprim
authors.initials: MM
authors.lastname: de Morais
authors.affiliation: Departamento de Neurologia, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Enedina Maria Lobato de
authors.initials: EM
authors.lastname: Oliveira
authors.affiliation: Departamento de Neurologia, Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Yuna
authors.initials: Y
authors.lastname: Ribeiro
authors.affiliation: Departamento de Neurologia, Instituto de Neurologia de Curitiba, Curitiba, PR, Brazil.
authors.forename: Henry Koiti
authors.initials: HK
authors.lastname: Sato
authors.affiliation: Departamento de Neurologia, Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Carlos Bernardo
authors.initials: CB
authors.lastname: Tauil
mesh_terms: D000328:Adult; D000368:Aged; D001919:Bradycardia / Q000139:chemically induced; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D005260:Female; D000068876:Fingolimod Hydrochloride; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D011409:Propylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D013110:Sphingosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D000068876:Fingolimod Hydrochloride; D013110:Sphingosine