Fingolimod-Associated Peripheral Vascular Adverse Effects

Mayo Clinic Proceedings
Margherita RussoRocco Salvatore Calabrò

Abstract

Fingolimod is the first oral disease-modifying drug approved for the treatment of multiple sclerosis. The drug is usually well tolerated, and common adverse effects include bradycardia, headache, influenza, diarrhea, back pain, increased liver enzyme levels, and cough. Fingolimod is thought to provide therapeutic benefit by preventing normal lymphocyte egress from lymphoid tissues, thus reducing the infiltration of autoaggressive lymphocytes into the central nervous system. However, because the drug acts on different sphingosine-1-phosphate receptors, it may induce several biological effects by influencing endothelial cell-cell adhesion, angiogenesis, vascular development, and cardiovascular function. We describe a patient with multiple sclerosis who, after 3 weeks of fingolimod administration, developed purplish blotches over the dorsal surface of the distal phalanges of the second and fifth digits and the middle phalanx of the fourth ray, itching, and edema on his left hand, without other evident clinical manifestations. When fingolimod therapy was discontinued, the clinical picture regressed within a few days but reappeared after a rechallenge test. Physicians should be aware of unexpected peripheral vascular adverse effects...Continue Reading

References

Jun 19, 2002·Biochimica Et Biophysica Acta·Wolfgang Siess
May 13, 2008·Biochimica Et Biophysica Acta·Yoh TakuwaNoriko Takuwa
Jan 22, 2010·The New England Journal of Medicine·Jeffrey A CohenUNKNOWN TRANSFORMS Study Group
Oct 30, 2010·Nature Reviews. Drug Discovery·Volker BrinkmannPascale Burtin
Mar 1, 2012·Neurology·Nieraj Jain, M Tariq Bhatti
Apr 2, 2013·Expert Opinion on Therapeutic Patents·Edward RobertsHugh Rosen
Dec 19, 2013·Development·Karen MendelsonTimothy Hla
May 31, 2014·Drug Design, Development and Therapy·Luigi di NuzzoFerdinando Nicoletti
Dec 3, 2014·American Heart Journal·John CammVolker Brinkmann

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Citations

Jun 19, 2016·The Journal of Pharmacology and Experimental Therapeutics·Anna Cantalupo, Annarita Di Lorenzo
May 22, 2017·Acta neurologica Belgica·Yara Dadalti Fragoso
Feb 23, 2019·The Journal of Physiology·Mayur J PatilBradley J Undem

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