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[Infections and fingolimod]

Carlos Cervera1

  • 1Hospital Clinic de Barcelona, 08036 Barcelona, Espana. ccervera@clinic.ub.es

Revista De Neurologia
|July 26, 2012
PubMed
Abstract

Insights

Fingolimod, an oral treatment for relapsing multiple sclerosis, causes reversible lymphopenia but does not increase opportunistic infection risk. However, potential herpesvirus infection risks warrant further investigation.

Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Fingolimod is an orally available medication for relapsing multiple sclerosis.
  • Its mechanism involves modulating lymphocyte circulation.

Purpose of the Study:

  • Review fingolimod's mechanism of action and infection risks.
  • Propose preventive strategies for patients.
  • Discuss fingolimod's role in progressive multifocal leukoencephalopathy.

Main Methods:

  • Analyzed fingolimod's antagonism of sphingosine 1-phosphate receptors.
  • Evaluated its effect on lymphocyte egress and redistribution.
  • Compared infection rates in fingolimod users versus placebo or interferon beta-1a.

Main Results:

  • Fingolimod induces selective, reversible lymphopenia by inhibiting lymphocyte egress.
  • No increased risk of opportunistic infections observed compared to controls.
  • Two cases of severe herpetic infections were reported.

Conclusions:

  • Fingolimod's lymphopenia appears safe regarding opportunistic infections due to preserved immuno-surveillance.
  • Herpesvirus infection risk requires consideration and further study.
  • More research is needed to confirm the association between fingolimod and herpesvirus infections.

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