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      Recurrence of disease activity during pregnancy after cessation of fingolimod in multiple sclerosis

      1 , 1 , 2 , 1

      Multiple Sclerosis Journal

      SAGE Publications

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          Abstract

          Fingolimod is an effective treatment for active relapsing-remitting multiple sclerosis (MS). Discontinuation of therapy may be followed by recurrence of disease activity. Thus, female MS patients may be at risk of relapse during pregnancy after stopping fingolimod.

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          Most cited references 9

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          Rebound Syndrome in Patients With Multiple Sclerosis After Cessation of Fingolimod Treatment.

          The appropriate sequencing of agents with strong immune system effects has become increasingly important. Transitions require careful balance between safety and protection against relapse. The cases presented herein highlight that rebound events after ceasing fingolimod treatment may happen even with short washout periods (4 weeks) and may perpetuate despite steroid treatment or the immediate use of fast-acting immune therapies, such as rituximab.
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            Natalizumab use during the third trimester of pregnancy.

            Natalizumab reduces multiple sclerosis relapses very effectively; however, severe disease activity may return once natalizumab treatment is withdrawn, as recommended during pregnancy. Sometimes restarting natalizumab treatment may be the best option for the mother, but the consequences for the infant are unknown. Except for a few single case reports, to our knowledge, comprehensive data about third-trimester natalizumab exposure are scant.
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              Pregnancy outcomes in the clinical development program of fingolimod in multiple sclerosis.

              To report outcomes of pregnancies that occurred during the fingolimod clinical development program.
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                Author and article information

                Journal
                Multiple Sclerosis Journal
                Mult Scler
                SAGE Publications
                1352-4585
                1477-0970
                May 18 2017
                June 2018
                September 18 2017
                June 2018
                : 24
                : 7
                : 991-994
                Affiliations
                [1 ]Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
                [2 ]Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany/The Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
                Article
                10.1177/1352458517731913
                28920764
                © 2018

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