Cardiac Repolarization During Fingolimod Treatment in Patients with Relapsing-remitting Multiple Sclerosis

Overview

Journal Brain Behav

Specialty Psychology

Date 2018 Feb 28

PMID 29484274

Citations 1

Authors

Aapo Laiho

Tiina M Laitinen

Paivi Hartikainen

Juha E K Hartikainen

Tomi P Laitinen

Sakari Simula

Affiliations

Soon will be listed here.

Abstract

Background: Fingolimod is a sphingosine-1-phosphate receptor modulator for the treatment of relapsing-remitting multiple sclerosis (RRMS). Despite an established effect on heart rate, the effect of fingolimod on cardiac repolarization is not completely known.

Methods: Twenty-seven patients with RRMS underwent 24-hr ambulatory ECG before fingolimod (baseline), at the day of fingolimod initiation (1D) and after three-month treatment (3M). The mean values of RR-interval as well as QT-interval corrected by Bazzet's (QTcBaz) and Fridericia's (QTcFri) formula were compared between baseline, 1D, and 3M over 24-hr period as well as at daytime and nighttime.

Results: QTcBaz over 24-hr was shorter at 1D (414 ± 20 ms, < .001) and at 3M (414 ± 20 ms, < .001) than at baseline (418 ± 20 ms). In contrast, QTcFri over 24-hr was longer at 1D (410 ± 19 ms, < .001) but similar at 3M (406 ± 19 ms, = .355) compared to baseline (407 ± 19 ms). Daytime QTcBaz was shorter at 1D ( < .001) and at 3M ( = .007), whereas daytime QTcFri was longer at 1D ( < .05) but similar at 3M ( = ns) compared to baseline. During the night, changes were observed neither in QTcBaz nor in QTcFri between baseline, 1D, and 3M.

Conclusions: Changes in cardiac repolarization after fingolimod initiation were mild and occurred at daytime. Ambiguously, QTcBaz demonstrated shortening, whereas QTcFri showed prolongation in cardiac repolarization after fingolimod initiation. The formula applied for QT-interval correction needs to be taken carefully into account as evaluating pharmacovigilance issues related to fingolimod.

Citing Articles

Cardiac repolarization during fingolimod treatment in patients with relapsing-remitting multiple sclerosis.

Laiho A, Laitinen T, Hartikainen P, Hartikainen J, Laitinen T, Simula S Brain Behav. 2018; 8(2):e00925.

PMID: 29484274 PMC: 5822581. DOI: 10.1002/brb3.925.

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