title: [Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in Navarra, Gipuzkoa and La Rioja].
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of fingolimod in clinical practice in Navarra, Gipuzkoa and La Rioja regions.
  
  
  METHODS
  We conducted a retrospective multi-centre study with recurrent multiple sclerosis patients treated with fingolimod, following the product data sheet. The following data were evaluated: annualised relapse rate (ARR), percentage of patients free from relapses, disability using the Expanded Disability Status Scale (EDSS) and the percentage of patients without gadolinium-enhancing lesions.
  
  
  RESULTS
  A total of 113 patients were treated with fingolimod: 6% were naive, and 58% and 35% were patients previously treated with an immunomodulator and natalizumab, respectively. Fingolimod lowered the ARR after the first (67%; 1 to 0.3; p < 0.0001) and second (89%; 1 to 0.1; p < 0.0001) years of treatment, and thus the number of patients free from relapses during the treatment increased. The baseline EDSS was 3 and after treatment with fingolimod was 2.5 in both years. The percentage of patients without gadolinium-enhancing lesions after the first year of treatment was 77%. Similar results were observed in naive patients and in those previously treated with an immunomodulator. In patients previously treated with natalizumab no changes were observed following the treatment.
  
  
  CONCLUSIONS
  The use of fingolimod in clinical practice showed an effectiveness similar to that observed in clinical trials. There were no changes in the ARR after changing from natalizumab, and only one patient presented a 'relapse' after withdrawal of natalizumab. Fingolimod acts like a safe drug, with scarce side effects and a low percentage of drop-outs.
authors.affiliation: Complejo Hospitalario de Navarra , Pamplona, Espana.
authors.forename: T
authors.initials: T
authors.lastname: Ayuso
authors.affiliation: Complejo Hospitalario San Millan-San Pedro, 26004 Logrono, Espana.
authors.forename: M E
authors.initials: ME
authors.lastname: Marzo-Sola
authors.affiliation: Hospital Donostia, 20014 San Sebastian, Espana.
authors.forename: T
authors.initials: T
authors.lastname: Castillo-Trivino
authors.affiliation: Complejo Hospitalario de Navarra , Pamplona, Espana.
authors.forename: G
authors.initials: G
authors.lastname: Soriano
authors.affiliation: Complejo Hospitalario de Navarra , Pamplona, Espana.
authors.forename: M A
authors.initials: MA
authors.lastname: Otano
authors.affiliation: Complejo Hospitalario San Millan-San Pedro, 26004 Logrono, Espana.
authors.forename: M A
authors.initials: MA
authors.lastname: Lopez
authors.affiliation: Hospital Donostia, 20014 San Sebastian, Espana.
authors.forename: I M
authors.initials: IM
authors.lastname: Croitoru
authors.affiliation: Hospital Donostia, 20014 San Sebastian, Espana.
authors.forename: J
authors.initials: J
authors.lastname: Olascoaga