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A case of early disease rebound after fingolimod discontinuation in a patient with multiple sclerosis and SARS-CoV-2 infection

  • COVID-19
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Abstract

Fingolimod is approved in Italy as a second-line therapy for relapsing–remitting multiple sclerosis (RRMS). Discontinuation of fingolimod may elevate the risk of relapses, typically manifesting after a relatively prolonged drug-free interval and often necessitating high doses of intravenous steroids for management. Similar to other viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can act as a trigger for MS relapses. In this context, we present a case of rebound following fingolimod discontinuation during a SARS-CoV-2 infection. Notably, the rebound occurred shortly after stopping the medication and responded effectively to low doses of oral steroids. Our case is discussed in light of existing literature, with speculation on potential mechanisms governing this unconventional disease course rebound. We also consider the possibility that SARS-CoV-2 infection might have contributed to or even triggered the MS relapse.

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References

  1. Barry B, Erwin AA, Stevens J, Tornatore C (2019) Fingolimod rebound: a review of the clinical experience and management considerations. Neurol Ther 8(2):241–250. https://doi.org/10.1007/s40120-019-00160-9

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hosseini N, Nadjafi S, Ashtary B (2021) Overview of covid-19 and neurological complications. Rev Neurosci 32(6):671–691. https://doi.org/10.1515/revneuro-2020-0116

    Article  CAS  PubMed  Google Scholar 

  3. Finsterer J (2022) SARS-CoV-2 triggered relapse of multiple sclerosis. Clin Neurol Neurosurg 215:107210. https://doi.org/10.1016/j.clineuro.2022.107210

    Article  PubMed  PubMed Central  Google Scholar 

  4. Cabreira V, Abreu P, Soares-Dos-reis R, Guimarães J, Sá MJ (2021) Multiple sclerosis, disease-modifying therapies and COVID-19: a systematic review on immune response and vaccination recommendations. Vaccines 9(7):1–18. https://doi.org/10.3390/vaccines9070773

    Article  CAS  Google Scholar 

  5. Goncuoglu C et al (2021) Factors associated with fingolimod rebound: a single center real-life experience. Mult Scler Relat Disord 56:103278. https://doi.org/10.1016/j.msard.2021.103278

    Article  CAS  PubMed  Google Scholar 

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Funding

No funding was received for conducting this study.

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Author notes

  1. Giovannini Beatrice and Deborah Panelli equally contributed to the manuscript.

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Clinical Neurology, University of Pisa, Pisa, Italy

    Beatrice Giovannini, Francesca Bianchi, Gabriele Siciliano & Livia Pasquali

  2. Lucca, Italy

    Deborah Panelli

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  1. Beatrice Giovannini
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  2. Deborah Panelli
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  3. Francesca Bianchi
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  4. Gabriele Siciliano
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  5. Livia Pasquali
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Correspondence to Beatrice Giovannini.

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This study was performed in line with the principles of the Declaration of Helsinki. The participant has consented to the submission of the case report to the journal.

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The authors declare that they have no conflict of interest.

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Giovannini, B., Panelli, D., Bianchi, F. et al. A case of early disease rebound after fingolimod discontinuation in a patient with multiple sclerosis and SARS-CoV-2 infection. Neurol Sci 45, 2423–2426 (2024). https://doi.org/10.1007/s10072-024-07490-z

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  • DOI: https://doi.org/10.1007/s10072-024-07490-z

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