Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis

Clemens Warnke1,2, Olaf Stüve3,4, Hans-Peter Hartung1, Anna Fogdell-Hahn2, Bernd C Kieseier11Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany; 2Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; 3Department of Neurology, Dal...

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Main Authors: Warnke C, Stüve O, Hartung HP, Fogdell-Hahn A, Kieseier B
Format: Article
Language:English
Published: Dove Medical Press 2011-09-01
Series:Neuropsychiatric Disease and Treatment
Online Access:http://www.dovepress.com/critical-appraisal-of-the-role-of-fingolimod-in-the-treatment-of-multi-a8235
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author Warnke C
Stüve O
Hartung HP
Fogdell-Hahn A
Kieseier B
author_facet Warnke C
Stüve O
Hartung HP
Fogdell-Hahn A
Kieseier B
author_sort Warnke C
collection DOAJ
description Clemens Warnke1,2, Olaf Stüve3,4, Hans-Peter Hartung1, Anna Fogdell-Hahn2, Bernd C Kieseier11Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany; 2Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; 3Department of Neurology, Dallas Veterans Affairs Medical Center, TX, USA; 4Department of Neurology, University of Texas Southwestern Medical Center at Dallas, TX, USAAbstract: This review summarizes Phase III clinical trial data available for fingolimod. The main purpose is to evaluate the benefit-risk profile of fingolimod, the first oral compound available for treatment of multiple sclerosis (MS) and just recently approved by the European authorities. The authors place this evaluation in the context of the known safety and efficacy profile of established compounds for therapy of MS to outline the current and future potential of fingolimod. The authors conclude that only long-term safety data from post-marketing surveillance plans, together with additional head-to-head studies, would allow evidence-based treatment decisions. Furthermore, risk-profile analyses including patient history, exposure data to certain pathogens, and genetic analyses may potentially help to choose the right drug for individual patients in the future. Until these approaches toward an individualized medicine have been validated, treatment decisions for one or the other compound will have to be based partly on class IV evidence. Therefore, a close dialog with the well-informed patient, secured by effective risk mitigation plans, is required to choose the compound.Keywords: FTY720, oral drug, spingosine 1-phosphate receptor
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spelling doaj.art-1f40c5bda7594a358c550787481ca1942022-12-21T22:59:21ZengDove Medical PressNeuropsychiatric Disease and Treatment1176-63281178-20212011-09-012011Issue 1519527Critical appraisal of the role of fingolimod in the treatment of multiple sclerosisWarnke CStüve OHartung HPFogdell-Hahn AKieseier BClemens Warnke1,2, Olaf Stüve3,4, Hans-Peter Hartung1, Anna Fogdell-Hahn2, Bernd C Kieseier11Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany; 2Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; 3Department of Neurology, Dallas Veterans Affairs Medical Center, TX, USA; 4Department of Neurology, University of Texas Southwestern Medical Center at Dallas, TX, USAAbstract: This review summarizes Phase III clinical trial data available for fingolimod. The main purpose is to evaluate the benefit-risk profile of fingolimod, the first oral compound available for treatment of multiple sclerosis (MS) and just recently approved by the European authorities. The authors place this evaluation in the context of the known safety and efficacy profile of established compounds for therapy of MS to outline the current and future potential of fingolimod. The authors conclude that only long-term safety data from post-marketing surveillance plans, together with additional head-to-head studies, would allow evidence-based treatment decisions. Furthermore, risk-profile analyses including patient history, exposure data to certain pathogens, and genetic analyses may potentially help to choose the right drug for individual patients in the future. Until these approaches toward an individualized medicine have been validated, treatment decisions for one or the other compound will have to be based partly on class IV evidence. Therefore, a close dialog with the well-informed patient, secured by effective risk mitigation plans, is required to choose the compound.Keywords: FTY720, oral drug, spingosine 1-phosphate receptorhttp://www.dovepress.com/critical-appraisal-of-the-role-of-fingolimod-in-the-treatment-of-multi-a8235
spellingShingle Warnke C
Stüve O
Hartung HP
Fogdell-Hahn A
Kieseier B
Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
Neuropsychiatric Disease and Treatment
title Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
title_full Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
title_fullStr Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
title_full_unstemmed Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
title_short Critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
title_sort critical appraisal of the role of fingolimod in the treatment of multiple sclerosis
url http://www.dovepress.com/critical-appraisal-of-the-role-of-fingolimod-in-the-treatment-of-multi-a8235
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