title: Two cases of relapses in primary progressive multiple sclerosis after fingolimod withdrawal.
abstract: We report two cases of primary progressive multiple sclerosis (PPMS) included in the INFORMS cohort, experiencing a relapse related to a single MRI gadolinium-enhancing lesion 3 months after fingolimod withdrawal. These two patients share similarities with relapsing-remitting multiple sclerosis cases described in the same situation, suggesting that the initiating process of the active demyelinating plaques is also present in PPMS, even without relapses, but may be triggered as fingolimod is withdrawn. Although the results of the INFORMS study suggest that fingolimod may not slow down the progression, some PPMS patients might still benefit from a disease-modifying treatment.
authors.affiliation: Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France. jbdavion@hotmail.fr.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Davion
authors.affiliation: Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France.|Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Cambron
authors.affiliation: Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Duhin
authors.affiliation: Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Chouraki
authors.affiliation: Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Lacour
authors.affiliation: Department of Neurology, University of Montpellier, Montpellier, France.
authors.forename: P
authors.initials: P
authors.lastname: Labauge
authors.affiliation: Department of Neurology, University of Montpellier, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Carra
authors.affiliation: Department of Neurology, University of Montpellier, Montpellier, France.
authors.forename: X
authors.initials: X
authors.lastname: Ayrignac
authors.affiliation: Univ. Lille, INSERM, CHU Lille, U995, LIRIC, Lille International Research Inflammation Center, 59000, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Vermersch
mesh_terms: D000068876:Fingolimod Hydrochloride / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy*; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: Fingolimod; INFORMS; Multiple sclerosis; Primary progressive; Relapse; Withdrawal