Audit on UHCW experience with Fingolimod in relapsing-remitting multiple sclerosis (RRMS)

MS Specialists MasterClass 6, 2019

Background:

Fingolimod is a licensed disease modifying therapy (DMT) for people with relapsing Multiple sclerosis. University Hospital Coventry serves 107 patients with Multiple Sclerosis on Fingolimod.

Objective:

We did an audit to assess the use of Fingolimod at UHCW against National guidelines to assess safety and efficacy.

Methods:

Patients were identified using Electronic Medical records and MS data. 107 patients with RRMS were identified, 82 of them had had Fingolimod for at least 12 months. We included patients who started on treatment between March 2013 and July 2017.

Results:

All patients were prescribed Fingolimod as a second-line DMT. 72% were females and 28% were males. Average age for commencement was 40.7 years. 67% of patients were changed to Fingolimod from Injectable’ Platform ’ DMTs . 16% were changed from other available oral DMTS at the time of inclusion (Aubagio and Tecfidera). 20 patients were changed from Natalizumab due to high risk of PML. 14 patients discontinued Fingolimod due to side effects. One patient only developed Macular oedema. 27 patients had a clinical relapse whilst on Fingolimod, 13 of them discontinued treatment.

Conclusion:

This Audit of Fingolimod use as a second line treatment for Relapsing Remitting Multiple Sclerosis supports the short-term safety and efficacy of Fingolimod in clinical practice. We identified areas that require improvement in our MS service. Those who were changed from Tysabri to Fingolimod benefited less compared to other DMTs.