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FDA warning on stopping Gilenya

Posted: Wed Nov 21, 2018 3:21 am
by Scott1
This came out today on the risks involved with stopping Gilenya

https://www.fda.gov/Drugs/DrugSafety/ucm626095.htm

"The Food and Drug Administration (FDA) is warning that when the multiple sclerosis (MS) medicine Gilenya (fingolimod) is stopped, the disease can become much worse than before the medicine was started or while it was being taken. This MS worsening is rare but can result in permanent disability. As a result, we have added a new warning about this risk to the prescribing information of the Gilenya drug label and patient Medication Guide."

Regards,

Re: FDA warning on stopping Gilenya

Posted: Wed Nov 21, 2018 8:44 am
by Zyklon
In the eight years since Gilenya’s 2010 approval, FDA received 35 cases of severe increase in disability accompanied by the presence of multiple new gadolinium-enhancing lesions on MRI following the discontinuation of Gilenya. All 35 patients received corticosteroids as the initial treatment. Of the six patients who were reported to have experienced a full recovery, 3 received only intravenous methylprednisolone, and the other 3 received plasma exchange, intrathecal triamcinolone, or re-started Gilenya. Other patients were also treated with plasma exchange, natalizumab, Gilenya, cyclophosphamide, rituximab, dimethyl fumarate, glatiramer, and methotrexate.
I think this is acceptable risk but needs more research.

Re: FDA warning on stopping Gilenya

Posted: Wed Nov 21, 2018 9:34 am
by ElliotB
acceptable risk> Not in my opinion, why be a test subject especially when there are other proven drugs that are proven reasonably safe.

needs more research > definitely

Re: FDA warning on stopping Gilenya

Posted: Thu Nov 22, 2018 1:25 am
by NHE
Zyklon wrote:
In the eight years since Gilenya’s 2010 approval, FDA received 35 cases of severe increase in disability accompanied by the presence of multiple new gadolinium-enhancing lesions on MRI following the discontinuation of Gilenya. All 35 patients received corticosteroids as the initial treatment. Of the six patients who were reported to have experienced a full recovery, 3 received only intravenous methylprednisolone, and the other 3 received plasma exchange, intrathecal triamcinolone, or re-started Gilenya. Other patients were also treated with plasma exchange, natalizumab, Gilenya, cyclophosphamide, rituximab, dimethyl fumarate, glatiramer, and methotrexate.
I think this is acceptable risk but needs more research.
"6/35" Only 17% experienced full recovery.

Re: FDA warning on stopping Gilenya

Posted: Thu Nov 22, 2018 11:59 am
by Zyklon
Out of how many patients? 35 cases in 100000? We need more data. We know lots of drugs are relatively safe to use. What about discontinue? I only know a little about immune reconstitution inflammatory syndrome. Please more research.