title: [Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in Asturias and Cantabria].
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of fingolimod in routine clinical practice in the region of Asturias and Cantabria (Spain).
  
  
  METHODS
  We conducted a retrospective multicentre study of patients with relapsing-remitting multiple sclerosis treated with fingolimod, in accordance with the product data sheet. Effectiveness was evaluated in patients with at least one year's treatment. The following were calculated: annualised relapse rate (ARR), the percentage of patients free from relapses and free from gadolinium-enhancing lesions, and those who improved/maintained their score on the Expanded Disability Status Scale (EDSS). Both total population and according to previous treatment: immunomodulator (interferon beta-1 or glatiramer acetate) or natalizumab, were analysed.
  
  
  RESULTS
  A total of 138 patients started treatment with fingolimod; 60% previously received an immunomodulator; 28% were given natalizumab; and 9% had no treatment. Ninety-nine patients were treated with fingolimod for at least one year. After one year of treatment, fingolimod decreased the ARR by 67% (1.26 to 0.42; p < 0.0001), increased the percentage of patients free from relapses from 24% to 69% (p < 0.0001) and the percentage of patients free from gadolinium-enhancing lesions from 70% to 85% (p < 0.0106). Altogether, 77% of the patients improved/maintained their score on the EDSS. Similar results were observed in patients previously treated with an immunomodulator. The effectiveness of the patients previously treated with natalizumab remained the same following treatment with fingolimod.
  
  
  CONCLUSIONS
  Routine clinical practice in the regions of Asturias and Cantabria shows that fingolimod yields similar results to those observed in clinical trials, on comparing the clinicoradiological variables used in them.
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: A
authors.initials: A
authors.lastname: Oterino
authors.affiliation: Hospital de Cabuenes, 33394 Gijon, Espana.
authors.forename: D F
authors.initials: DF
authors.lastname: Uria
authors.affiliation: Hospital San Agustin, 33400 Aviles, Espana.
authors.forename: J
authors.initials: J
authors.lastname: Pena
authors.affiliation: Hospital de Cabuenes, 33394 Gijon, Espana.
authors.forename: D
authors.initials: D
authors.lastname: Solar
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: J
authors.initials: J
authors.lastname: Villafani
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: P
authors.initials: P
authors.lastname: Oliva-Nacarino
authors.affiliation: Hospital de Cabuenes, 33394 Gijon, Espana.
authors.forename: R
authors.initials: R
authors.lastname: Suarez-Moro
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: V G
authors.initials: VG
authors.lastname: Quintanilla