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- Title
Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
- Authors
Orrico, Mario; Nozzolillo, Agostino; Gelibter, Stefano; Sangalli, Francesca; Preziosa, Paolo; Filippi, Massimo; Moiola, Lucia
- Abstract
During the COVID-19 pandemic, concerns raised regarding the use of immunosuppressants in multiple sclerosis, even if current data do not support an increased risk of infection. Although fingolimod can be temporarily suspended during COVID-19, the benefit-risk balance of suspension can be challenging. Till now, no adverse events have been described after the resumption of fingolimod, following a previous discontinuation. We report the occurrence of atrioventricular block following fingolimod restart. Fingolimod acts on sphingosine-1-phosphate-axis, a pathway that is altered with COVID-19 and hypoxic conditions. Herein we discuss how these metabolic changes may have influenced fingolimod pharmacology leading to a cardiac event.
- Subjects
COVID-19; COVID-19 pandemic; FINGOLIMOD; SPHINGOSINE-1-phosphate; IMMUNOSUPPRESSIVE agents
- Publication
Journal of Neurology, 2021, Vol 268, Issue 11, p3975
- ISSN
0340-5354
- Publication type
Case Study
- DOI
10.1007/s00415-021-10556-z