Cladribine to treat disease exacerbation after fingolimod discontinuation in progressive multiple sclerosis.
Cesar Alvarez-GonzalezAshok AdamsJoela MathewsBenjamin P TurnerGavin GiovannoniDavid BakerKlaus SchmiererPublished in: Annals of clinical and translational neurology (2017)
Rebound disease following cessation of disease modifying treatment (DMT) has been reported in people with both relapsing and progressive multiple sclerosis (pwRMS, pwPMS) questioning strict separation between these two phenotypes. While licensed DMT is available for pwRMS to counter rebound disease, no such option exists for pwPMS. We report on a pwPMS who developed rebound disease, with 45 Gadolinium-enhancing lesions on T1 weighted MRI brain, within 6 months after fingolimod 0.5 mg/day was stopped. Treatment with a short course of subcutaneous cladribine 60 mg led to effective suppression of inflammatory activity and partial recovery with no short-term safety issues or adverse events.
Keyphrases
- multiple sclerosis
- white matter
- contrast enhanced
- magnetic resonance imaging
- chronic obstructive pulmonary disease
- magnetic resonance
- brain injury
- computed tomography
- systemic lupus erythematosus
- resting state
- mass spectrometry
- functional connectivity
- replacement therapy
- cerebral ischemia
- diffusion weighted imaging
- network analysis