Real world effectiveness of fingolimod in patients with relapsing remitting multiple sclerosis and non-response to previous treatment: a prospective analysis in Buenos Aires, Argentina

ROJAS JUAN IGNACIO; SANCHEZ FRANCISCO; MIGUEZ, JIMENA; PATRUCCO LILIANA; CRISTIANO EDGARDO

Berlin

Congreso; 34TH Congress of the European Comitee for Treatment and Research in Multiple Sclerosis; 2018

European Comitee for Treatment and Research in Multiple Sclerosis (ECTRIMS)

Introduction: Growing evidence demonstrated the effectiveness of fingolimod in the real world (RW) setting, however scarce information exists from Latin America. The aim of this prospective study was to evaluate fingolimod effectiveness in non-responders to treatment patients in Buenos Aires, Argentina. Methods: non-responders to first immunomodulating treatment who were prescribed fingolimod and at least ³18 months of follow up were included during August 2013 and June 2018. Non-response was defined as patients who experienced 1 relapse in the previous year and at least 1 T1 Gd+ lesion or 9 or more T2 lesions or ≥3 new or enlarged T2 or T1 GAD+ lesions while on therapy. Three-monthly clinical evaluations and 12-monthly magnetic resonance were performed. Demographic and clinical variables were described as well as the effectiveness outcomes that included the proportion of patients free from clinical relapses, from disability progression, from new or enlarging T2 or T1 gadolinium-enhancing lesions on annual MRI and from any disease activity during the follow up. Results: 97 patients were included: 68 % female (n =66); mean age 30 ± 10.5 years; mean disease duration 6.5 ± 3.1 years; mean EDSS 3.5 ±1, mean fingolimod use 30 ± 13 months (range 18-68 months). All patients used previous therapy (interferons n = 78; glatiramer acetate n= 12; teriflunomide n= 7). 15 patients (15.4 %) discontinued/ withdrew fingolimod (12 due to disease activity and 3 due to tolerance and personal decisions). 74 %were free from clinical relapses and 79% were free from disability progression; 65% of patients remained free from new or newly enlarging T2 lesions and 76% of patients were free from gadolinium enhancing lesions. The proportion of patients free from any disease activity was 54%. Conclusions: We observed a high effectiveness data of fingolimod in non-response to previous treatment in a newly RW settingDisclosure: The sudy was done without external support.