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Curr Neurol Neurosci Rep. 2011 Oct;11(5):492-7. doi: 10.1007/s11910-011-0216-9.

Fingolimod for multiple sclerosis: mechanism of action, clinical outcomes, and future directions.

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  • 1Department of Neurology and Department of Biomedicine, University Hospital Basel, Petersgraben, Switzerland.


The oral sphingosine 1-phosphate receptor (S1PR) modulator fingolimod functionally antagonizes S1PR hereby blocking lymphocyte egress from secondary lymphoid organs to the peripheral blood circulation. This results in a reduction in peripheral lymphocyte counts, including potentially encephalitogenic T cells. In patients with relapsing multiple sclerosis fingolimod has been shown to be an effective treatment. In phase 2 and phase 3 studies fingolimod-treated patients had reduced disease activity clinically and in MRI. Although severe infectious complications occurred in single cases treated with fingolimod, the frequency of overall infections was comparable in fingolimod-treated patients and controls. Overall, in clinical studies fingolimod was well tolerated and had a favorable safety profile. In follow-up studies with continuous fingolimod, treatment showed sustained efficacy while being well tolerated.

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