title: Severe dyspnoea with alteration of the diffusion capacity of the lung associated with fingolimod treatment.
abstract: In phase II clinical trial, fingolimod at a dose of 5.0mg (ten times higher than the currently approved dose) induced dyspnoea and decreased forced expiratory flow in some patients, probably trought an airways constriction S1P4-mediated. In phase III trials, respiratory adverse events associated with fingolimod treatment as dyspnoea, cough, oropharingeal pain and nasal congestion are reported with the same incidence of placebo. Here we report two cases of severe dyspnoea with alteration of the diffusion capacity of the lung associated with fingolimod treatment, which led to permanent treatment withdrawal.
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Bianco
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Agata Katia
authors.initials: AK
authors.lastname: Patanella
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Nociti
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Fino
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lucchini
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Francesco Lo
authors.initials: FL
authors.lastname: Savio
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy; IRCSS San Raffaele Pisana Roma, Rome, Italy.
authors.forename: Paolo Maria
authors.initials: PM
authors.lastname: Rossini
authors.affiliation: Institute of Neurology, Catholic University, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mirabella
mesh_terms: D000328:Adult; D004417:Dyspnea / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology*; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology*; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: Adverse event; Fingolimod; Multiple sclerosis; Respiratory; Side effect