title: [Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in the province of Alicante].
abstract: BACKGROUND
  Post-authorisation studies are important to confirm whether the outcomes of clinical trials are reproduced in usual clinical practice.
  
  
  OBJECTIVE
  To evaluate the effectiveness and safety of fingolimod in clinical practice in the province of Alicante.
  
  
  METHODS
  A retrospective multi-centre study was conducted with remitting multiple sclerosis patients treated with fingolimod. Demographic, clinical and pharmacological data were collected. We report on the effectiveness of the drug -annualised relapse rate (ARR) and percentage of patients free from attacks- at one and at two years after treatment in relation to the previous year, and data concerning side effects are also provided.
  
  
  RESULTS
  The sample consisted of 89 patients. Previous treatment was with immunomodulators (interferon beta or glatiramer acetate) in 54 patients and natalizumab in 32. Fifty patients changed due to failure with the immunomodulator and 31 owing to positive serology for JC virus (JCV+). Overall ARR decreased by 67.3% the first year (p < 0.0001) and by 84.1% the second (p = 0.0078). It diminished in patients with immunomodulator failure (85.6% the first year, p < 0.0001; 88.9% the second year, p = 0.0039) and increased in a non-significant manner in JCV+ patients in the first year. The percentage of patients free from relapses in the overall population increased from 32.6% to 68.1% in the first year (p < 0.0019) and to 82.6% in the second (p = 0.0215). This increase was not observed in JCV+ patients. Side effects were reported by 13 patients, which led to the drug being withdrawn in two of them.
  
  
  CONCLUSIONS
  In clinical practice in the province of Alicante, levels of effectiveness and safety of fingolimod proved to be slightly higher than those found in clinical trials.
authors.affiliation: Hospital General de Elda, 03600 Elda, Espana.
authors.forename: J
authors.initials: J
authors.lastname: Mallada
authors.affiliation: Hospital de la Marina Baixa, Villajoyosa, Espana.
authors.forename: N
authors.initials: N
authors.lastname: Perez-Carmona
authors.affiliation: Hospital de la Marina Baixa, Villajoyosa, Espana.
authors.forename: L
authors.initials: L
authors.lastname: Berenguer-Ruiz
authors.affiliation: Hospital General Universitario de Alicante, Alicante, Espana.
authors.forename: R
authors.initials: R
authors.lastname: Sanchez-Perez
authors.affiliation: Hospital Clinico Universitario de San Juan, 03550 San Juan, Espana.
authors.forename: R
authors.initials: R
authors.lastname: Martin-Gonzalez
authors.affiliation: Hospital General Universitario de Elche, 03203 Elche, Espana.
authors.forename: D
authors.initials: D
authors.lastname: Sola-Martinez
authors.affiliation: Hospital Vega Baja, 03314 Orihuela, Espana.
authors.forename: S
authors.initials: S
authors.lastname: Mola
authors.affiliation: Hospital Virgen de los Lirios, 03804 Alcoy, Espana.
authors.forename: J M
authors.initials: JM
authors.lastname: Lopez-Arlandis
authors.affiliation: Hospital de Torrevieja, Torrevieja, Espana.
authors.forename: R
authors.initials: R
authors.lastname: Vela-Yebra
authors.affiliation: Hospital Marina Salud, Denia, Espana.
authors.forename: L
authors.initials: L
authors.lastname: Gabaldon-Torres
authors.affiliation: Hospital General Universitario de Elche, 03203 Elche, Espana.
authors.forename: E
authors.initials: E
authors.lastname: Freire-Alvarez
authors.affiliation: Hospital IMED-Levante, Benidorm, Espana.
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Escriva
authors.affiliation: Hospital General Universitario de Alicante, Alicante, Espana.
authors.forename: A P
authors.initials: AP
authors.lastname: Sempere