title: Canadian Experience with Fingolimod: Adherence to Treatment and Monitoring.
abstract: BACKGROUND
  The Canadian GILENYA® Go ProgramTM provides education and support to people with relapsing-remitting multiple sclerosis during fingolimod treatment.
  
  
  METHODS
  Data were collected and analyzed from the time of the first individual enrolled in March 2011 to March 31, 2014. Individuals were excluded if they withdrew from the program prior to receiving the first dose, or had not completed the first dose observation (FDO) at the time of data cut-off. Reports of adverse effects were validated with a database of adverse events reported to Novartis Pharmaceuticals Canada Inc.
  
  
  RESULTS
  A total of 2,399 individuals had completed FDO at the end of the three-year observation period. Mean age was 41.2 years; 75.2% were female. The most recent prior therapies reported were interferon-β agents (50.2%), glatiramer acetate (31.1%), natalizumab (14.2%), no prior therapy (3.3%), and other agent (1.1%). Reasons for switching to fingolimod were lack of efficacy (34.9%), side effects (34.6%), and dissatisfaction with injections/infusion (30.4%). Continuation rates with fingolimod at 12, 24 and 30 months were 80.7%, 76.6% and 76.0%, respectively. The discontinuation rate due to reported lack of efficacy during the three-year period was 1.3%. There was 94.4% adherence to the scheduled ophthalmic examination.
  
  
  CONCLUSIONS
  The GILENYA® Go ProgramTM captures data for virtually all fingolimod-treated patients in Canada, enabling the evaluation of fingolimod use in routine practice. Ongoing patient support and reminders to take the medication, in conjunction with physicians' and/or patients' perception of the efficacy and tolerability of fingolimod, resulted in a high rate of continuation during longer-term therapy.
authors.affiliation: 1McGill University Health Centre,Montreal,Quebec.
authors.forename: Yves
authors.initials: Y
authors.lastname: Lapierre
authors.affiliation: 2St. Michael's Hospital,Toronto,Ontario.
authors.forename: Paul
authors.initials: P
authors.lastname: O'Connor
authors.affiliation: 3University of British Columbia Hospital,Vancouver,British Columbia.
authors.forename: Virginia
authors.initials: V
authors.lastname: Devonshire
authors.affiliation: 4The University of Ottawa and the Ottawa Hospital Research Institute,Ottawa,Ontario.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Freedman
authors.affiliation: 5London Health Sciences Centre,London,Ontario.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kremenchutzky
authors.affiliation: 6Foothills Medical Centre,Calgary,Alberta.
authors.forename: Michael
authors.initials: M
authors.lastname: Yeung
authors.affiliation: 7Novartis Pharmaceuticals Canada Inc.,Dorval,Quebec.
authors.forename: Robyn
authors.initials: R
authors.lastname: Schecter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D012042:Registries; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: adherence; fingolimod; monitoring; multiple sclerosis; patient support