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- Title
A case of early disease rebound after fingolimod discontinuation in a patient with multiple sclerosis and SARS-CoV-2 infection.
- Authors
Giovannini, Beatrice; Panelli, Deborah; Bianchi, Francesca; Siciliano, Gabriele; Pasquali, Livia
- 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.
- Subjects
ITALY; SARS-CoV-2; MULTIPLE sclerosis; FINGOLIMOD; JOHN Cunningham virus
- Publication
Neurological Sciences, 2024, Vol 45, Issue 6, p2423
- ISSN
1590-1874
- Publication type
Article
- DOI
10.1007/s10072-024-07490-z