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Fingolimod-associated macular edema: Incidence, detection, and management

Neurology, 2012-02, Vol.78 (9), p.672-680 [Peer Reviewed Journal]

2015 INIST-CNRS ;ISSN: 0028-3878 ;EISSN: 1526-632X ;DOI: 10.1212/WNL.0b013e318248deea ;PMID: 22371414 ;CODEN: NEURAI

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Title:
Fingolimod-associated macular edema: Incidence, detection, and management
Author: JAIN, Nieraj ; BHATTI, M. Tariq
Subjects: Biological and medical sciences ; Fingolimod Hydrochloride ; Human viral diseases ; Humans ; Infectious diseases ; Macular Edema - chemically induced ; Macular Edema - diagnosis ; Macular Edema - therapy ; Medical sciences ; Multiple Sclerosis, Relapsing-Remitting - drug therapy ; Neurology ; Propylene Glycols - adverse effects ; Propylene Glycols - therapeutic use ; Sphingosine - adverse effects ; Sphingosine - analogs & derivatives ; Sphingosine - therapeutic use ; Viral diseases ; Viral diseases of the nervous system
Is Part Of: Neurology, 2012-02, Vol.78 (9), p.672-680
Description: Fingolimod (FTY-720), a sphingosine-1-phosphate receptor modulator, is the first US Food and Drug Administration (FDA)-approved oral agent for the treatment of relapsing forms of multiple sclerosis (MS). Two recent phase III clinical studies (TRANSFORMS [Trial Assessing Injectable Interferon vs FTY720 Oral in RRMS] and FREEDOMS [FTY720 Research Evaluating Effects of Daily Oral Therapy in MS]) demonstrated a significant reduction in the annualized relapse rate in patients with relapsing-remitting MS, compared to once weekly interferon β-1a and placebo. Macular edema was a prominent adverse event reported in these and prior studies of fingolimod. Thirteen of 2,564 (0.5%) patients treated with fingolimod in FREEDOMS and TRANSFORMS developed macular edema. Fingolimod-associated macular edema (FAME) appears to be dose-dependent (observed in only 2 patients taking the FDA-approved 0.5 mg dose) and typically resolves upon cessation of therapy. Although a relatively common condition in ophthalmology, most neurologists have not encountered macular edema in clinical practice. The purpose of this review is to educate the neurologist on the etiology, clinical manifestations, diagnostic modalities, and treatment approaches in patients with FAME. We also discuss the use of fingolimod in patients with uveitis and diabetes mellitus, highlight the guidelines for surveillance ophthalmic examination, and outline the key distinguishing features between FAME and optic neuritis.
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
Language: English
Identifier: ISSN: 0028-3878
EISSN: 1526-632X
DOI: 10.1212/WNL.0b013e318248deea
PMID: 22371414
CODEN: NEURAI
Source: MEDLINE
Alma/SFX Local Collection

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Fingolimod-associated macular edema: Incidence, detection, and management

2015 INIST-CNRS ;ISSN: 0028-3878 ;EISSN: 1526-632X ;DOI: 10.1212/WNL.0b013e318248deea ;PMID: 22371414 ;CODEN: NEURAI

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