title: Effects of Three Months Fingolimod Therapy on Heart Rate.
abstract: Fingolimod is a novel disease-modifying drug for relapsing-remitting multiple sclerosis (RRMS). Fingolimod initiation associates with a decrease in heart rate (HR). However, the long-term effects of fingolimod on HR are not known. The aim of this study was prospectively investigate the effect of 3-month fingolimod therapy on HR. Twenty-seven RRMS patients underwent 24-h ambulatory electrocardiogram recording 20 ± 16 days before (baseline) and at the day of fingolimod initiation (1 day). Twenty-four patients completed 3 months follow-up (3 months). The average HR over 24-h and the average HR for daytime and nighttime were assessed at baseline, 1 day and 3 months. Fingolimod initiation resulted in slowing of HR from 82 ± 11 1/min at baseline to 63 ± 9.5 1/min at 5 h after the initiation of the therapy. The average HR during 24-h was lower at 1d (66 ± 7.8 1/min;p < 0.001) and also at 3 months (69 ± 8.3 1/min;p < 0.001) as compared to baseline (74 ± 10 1/min). The average daytime HR at 1 day (68 ± 8.4 1/min) was lower as compared to baseline (78 ± 11 1/min, p < 0.001), whereas no difference was found between the average daytime HR at baseline and at 3 months (79 ± 10 1/min). The average nighttime HR at 1 day (59 ± 8.8 1/min;p < 0.001) and at 3 months (60 ± 9.2 1/min;p < 0.05) both were lower than at baseline (64 ± 9.9 1/min). In conclusion, fingolimod resulted in HR decrease reaching the nadir at 5 h after the first dose. HR remained lower after 3 months fingolimod treatment as compared to baseline. Particularly, HR at daytime recovered whereas the nighttime HR showed not recovery as compared to the day of fingolimod initiation.
authors.affiliation: Department of Neurology, Mikkeli Central Hospital, Porrassalmenkatu 35-37, 50100, Mikkeli, Finland. sakari.simula@esshp.fi.
authors.forename: Sakari
authors.initials: S
authors.lastname: Simula
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors.forename: Tiina M
authors.initials: TM
authors.lastname: Laitinen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Tarkiainen
authors.affiliation: Heart Center, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors.forename: Juha E K
authors.initials: JE
authors.lastname: Hartikainen
authors.affiliation: Neuro Center, Department of Neurology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Hartikainen
mesh_terms: D000328:Adult; D004562:Electrocardiography; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000008:administration & dosage / Q000494:pharmacology*; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: Disease modifying therapies; Fingolimod; Heart rate; Multiple sclerosis