title: Safety and efficacy of fingolimod in clinical practice: The experience of an academic center in the Middle East.
abstract: BACKGROUND
  Few published studies addressed real-world clinical experience with fingolimod especially in the Middle East region.
  
  
  OBJECTIVE
  To review our clinical experience with fingolimod at a specialized academic MS center in Lebanon.
  
  
  METHODS
  All patients treated with fingolimod at the MS Center between October 2011 and January 2015 were retrospectively identified.
  
  
  RESULTS
  A total of 122 patients were included. The first dose observation was uneventful in 98.8% of patients. Annualized relapse rate decreased from 1.16 pre-treatment to 0.29 post-treatment representing a relative risk reduction of 75% (p<0.0001). The proportion of patients with no new T2 or enhancing lesions was 66.3%. Seventy-six (62.3%) patients experienced adverse events with lymphopenia, increase liver enzymes, urinary tract infections and fatigue being the most common.
  
  
  CONCLUSIONS
  Our cohort confirms the effectiveness and safety of fingolimod in a real world setting.
authors.affiliation: Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Bassem I
authors.initials: BI
authors.lastname: Yamout
authors.affiliation: Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Maya M
authors.initials: MM
authors.lastname: Zeineddine
authors.affiliation: Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.affiliation: Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: sk88@aub.edu.lb.
authors.forename: Samia J
authors.initials: SJ
authors.lastname: Khoury
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: Clinical; Efficacy; Fingolimod; Lebanon; Middle East; Multiple sclerosis