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Fingolimod: a review of its mode of action in the context of its efficacy and safety profile in relapsing forms of multiple sclerosis

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Abstract

Fingolimod is an orally administered, first-in-class therapy for the treatment of relapsing forms of multiple sclerosis. Data from pivotal clinical trials show that fingolimod has a robust, significant effect on annualized relapse rates and MRI outcomes. Fingolimod has a novel, well-characterized mechanism of action. It acts through a specific set of receptors, sphingosine 1-phosphate receptors, present on the surface of a wide range of human cells and tissues, including neural cells, neurons and lymphocytes. Here we review the current literature to describe the mechanism of action of fingolimod in the context of its well-established clinical efficacy and safety profile. Understanding of the mechanisms behind any non-therapeutic effects of fingolimod facilitates their prediction and management in the clinical setting.

Acknowledgments

This article represents the opinion of the authors. The authors interpreted the literature, critically revised content for important intellectual aspects and approved the content for publication. Stephen Georgiou, PhD, and Sarah Griffiths, PhD, of Oxford PharmaGenesis, Oxford, UK, provided technical writing and editorial support. Funding support and review of the accuracy of scientific data was provided by Novartis Pharmaceuticals Corporation, USA.

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