CHIH-CHAO YANGRo L.-S.Tsai N.-W.Lin C.-C.Huang W.-N.Tsai C.-P.Lin T.-S.JEN-JEN SUHuang C.-C.Lyu R.-K.Chen H.-H.Lee W.-J.Chen P.-L.Yang A.2021-12-022021-12-022021-019296646https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087791902&doi=10.1016%2fj.jfma.2020.07.002&partnerID=40&md5=fcbda930a2b8dd29aece7a2261a17e20https://scholars.lib.ntu.edu.tw/handle/123456789/589527Background/Purpose: Multiple sclerosis is classified as a rare disease in Taiwan. This study evaluated the safety and effectiveness of fingolimod in patients with relapsing-remitting multiple sclerosis (RRMS) from routine clinical practice in Taiwan. Methods: In this retrospective, multicentre, observational study, we collected clinical data of patients treated with fingolimod 0.5 mg/day in routine clinical practice between September 2012 and December 2015. Primary outcome was the overall safety of fingolimod; secondary outcome was the annualized relapse rate (ARR). Results: Overall, 62/69 (86.1%) patients were on fingolimod by the end of data collection period. Mean age (±standard deviation [SD]) at inclusion was 37.7 ± 10.10 years; mean duration of MS was 5.4 ± 4.52 years and mean duration of fingolimod exposure was 135.8 patient-years. The most common adverse events (AEs) were bradycardia (21.7%; first-dose related), upper respiratory tract infection, dizziness, and hypoaesthesia (numbness) (11.6% each), followed by urinary tract infection and back pain (7.2% each). Seven patients had liver enzyme-related AEs. Eight patients had absolute lymphocyte counts <0.2 × 103/uL over the study period. One patient developed second degree AV block after first-dosing. Serious AEs were observed in 11 patients (15.9%; mild-to-moderate). No newly developed macular oedema was detected. The ARR was 0.3 ± 0.74 in fingolimod-treated patients and 66.7% of patients were relapse-free. The mean (SD) change from baseline in expanded disability status scale score was ?0.30 ± 1.353. Conclusion: Fingolimod 0.5 mg/day treatment with an average of 2 years of exposure was associated with a manageable safety profile, and maintained/improved effectiveness in RRMS patients from Taiwan. ? 2020 Formosan Medical AssociationEffectiveness and safety; Fingolimod; Multiple sclerosis; Real-world; Taiwan[SDGs]SDG3alanine aminotransferase; aspartate aminotransferase; fingolimod; fingolimod; immunosuppressive agent; abdominal pain; adult; anemia; anxiety disorder; Article; backache; blurred vision; bradycardia; cerebrovascular accident; clinical practice; cohort analysis; conjunctivitis; controlled study; depression; disease duration; dizziness; drug efficacy; drug exposure; drug safety; dry eye; Expanded Disability Status Scale; face pain; fatigue; female; fever; headache; hemiplegia; herpes zoster; human; hypertransaminasemia; hypesthesia; insomnia; lymphocyte count; major clinical study; male; multiple sclerosis; muscle spasm; muscle weakness; neck pain; observational study; pelvic inflammatory disease; perianal abscess; recurrence risk; retrospective study; second degree atrioventricular block; seizure; side effect; Taiwan; upper respiratory tract infection; urinary tract infection; urosepsis; viral upper respiratory tract infection; clinical trial; middle aged; multicenter study; tumor recurrence; Adult; Fingolimod Hydrochloride; Humans; Immunosuppressive Agents; Middle Aged; Multiple Sclerosis; Neoplasm Recurrence, Local; Retrospective Studies; Taiwanjournal article10.1016/j.jfma.2020.07.002326692332-s2.0-85087791902