New research has shown fingolimod 0.5mg, a first-line treatment for multiple sclerosis (MS), reduces both the number of relapses and disease progression in patients with relapsing-remitting MS and may also reduce the incidence of uveitis, which is higher in this group than in the general population.
However, it may also cause fingolimod-associated macular oedema (FAME), with patients requiring close observation, said Dr Bradley Smith of The Retina Institute, St. Louis, when presenting the findings at the American Academy of Ophthalmology’s virtual 2020 annual meeting.
Analysing the records of 188 MS patients, followed-up from one to 104 months (mean: 60.9) after treatment with fingolimod 0.5mg, Dr Smith and his team found no patient had developed uveitis and Fingolimod was well tolerated. Acute macular neuroretinopathy developed in one patient, while 26 patients had a history of optic neuritis, of whom seven had a recurrence during the study. FAME developed in three patients, none of whom had intraocular inflammation or other identifiable cause of macular oedema; they were successfully treated with topical therapy.
Fingolimod blocks the movement of central memory T-cells from the lymph nodes to the bloodstream and has been shown to have a favourable effect on experimental autoimmune uveitis mice models, said Dr Smith. “Our retrospective review suggests possible efficacy against the development of uveitis in an at-risk population that is consistent with fingolimod’s anti-inflammatory effect in animal models.” Further research is required to firmly establish this is the case, he added.
The full study was published in the Journal of Ophthalmic Inflammation and Infection.
