Incidence of Uveitis and Macular Edema Among Patients Taking Fingolimod 0.5 mg for Multiple Sclerosis

Overview

Journal J Ophthalmic Inflamm Infect

Publisher Springer

Specialty Ophthalmology

Date 2020 Sep 21

PMID 32954456

Citations 1

Authors

Scott Joseph Sonne

Bradley Thomas Smith

Affiliations

Soon will be listed here.

Abstract

Background: Patients with multiple sclerosis (MS) have a higher incidence of uveitis compared with the general population. Fingolimod, a first line disease modifying drug used in multiple sclerosis, may cause macular edema and thus requires ophthalmic examination. However, murine models and anecdotal reports suggest fingolimod may reduce the incidence of uveitis.

Purpose: To report the incidence of uveitis and macular edema among those on fingolimod 0.5 mg (Gilenya®) therapy for multiple sclerosis (MS).

Methods: Retrospective review of patients on fingolimod who developed uveitis and/or macular edema.

Results: No patients had an occurrence or history of uveitis. Four of the 188 (2.13%) patients developed macular edema without ocular inflammation. One of the 188 (0.53%) patients developed Acute Macular Neuroretinopathy.

Conclusion: Patients taking fingolimod have a lower incidence of uveitis than expected in a population of MS patients.

Citing Articles

Diagnosis and Management of Fingolimod-Associated Macular Edema.

Wang C, Deng Z, Song L, Sun W, Zhao S Front Neurol. 2022; 13:918086.

PMID: 35911881 PMC: 9334868. DOI: 10.3389/fneur.2022.918086.

References

Le Scanff J, Seve P, Renoux C, Broussolle C, Confavreux C, Vukusic S . Uveitis associated with multiple sclerosis. Mult Scler. 2008; 14(3):415-7. DOI: 10.1177/1352458507083444. View

Cohen J, Barkhof F, Comi G, Hartung H, Khatri B, Montalban X . Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med. 2010; 362(5):402-15. DOI: 10.1056/NEJMoa0907839. View

Shah S, Goren J, Lazzara M, Strominger M, Hedges 3rd T, Duker J . Acute macular neuroretinopathy associated with the use of norepinephrine reuptake inhibitors: a case series and OCT findings. Retin Cases Brief Rep. 2014; 7(2):146-9. DOI: 10.1097/ICB.0b013e318274a74c. View

Zein G, Berta A, Foster C . Multiple sclerosis-associated uveitis. Ocul Immunol Inflamm. 2004; 12(2):137-42. DOI: 10.1080/09273940490895344. View

Cugati S, Chen C, Lake S, Lee A . Fingolimod and macular edema: Pathophysiology, diagnosis, and management. Neurol Clin Pract. 2018; 4(5):402-409. PMC: 5765686. DOI: 10.1212/CPJ.0000000000000027. View

Turbeville S, Cowan L, Gass J . Acute macular neuroretinopathy: a review of the literature. Surv Ophthalmol. 2003; 48(1):1-11. DOI: 10.1016/s0039-6257(02)00398-3. View

Bhavsar K, Lin S, Rahimy E, Joseph A, Freund K, Sarraf D . Acute macular neuroretinopathy: A comprehensive review of the literature. Surv Ophthalmol. 2016; 61(5):538-65. DOI: 10.1016/j.survophthal.2016.03.003. View

Thouvenot E, Mura F, de Verdal M, Carlander B, Charif M, Schneider C . Ipsilateral uveitis and optic neuritis in multiple sclerosis. Mult Scler Int. 2012; 2012:372361. PMC: 3507049. DOI: 10.1155/2012/372361. View

Kaya D, Kaya M, Ozakbas S, Idiman E . Uveitis associated with multiple sclerosis: complications and visual prognosis. Int J Ophthalmol. 2014; 7(6):1010-3. PMC: 4270967. DOI: 10.3980/j.issn.2222-3959.2014.06.18. View

10.

Raveney B, Copland D, Nicholson L, Dick A . Fingolimod (FTY720) as an acute rescue therapy for intraocular inflammatory disease. Arch Ophthalmol. 2008; 126(10):1390-5. DOI: 10.1001/archopht.126.10.1390. View

11.

Zarbin M, Jampol L, Jager R, Reder A, Francis G, Collins W . Ophthalmic evaluations in clinical studies of fingolimod (FTY720) in multiple sclerosis. Ophthalmology. 2013; 120(7):1432-9. DOI: 10.1016/j.ophtha.2012.12.040. View

12.

Budde K, Schutz M, Glander P, Peters H, Waiser J, Liefeldt L . FTY720 (fingolimod) in renal transplantation. Clin Transplant. 2006; 20 Suppl 17:17-24. DOI: 10.1111/j.1399-0012.2006.00596.x. View

13.

Copland D, Liu J, Schewitz-Bowers L, Brinkmann V, Anderson K, Nicholson L . Therapeutic dosing of fingolimod (FTY720) prevents cell infiltration, rapidly suppresses ocular inflammation, and maintains the blood-ocular barrier. Am J Pathol. 2011; 180(2):672-81. PMC: 3796282. DOI: 10.1016/j.ajpath.2011.10.008. View

14.

Karara A, Macky T, Sharawy M . Pattern of uveitis in an Egyptian population with multiple sclerosis: a hospital-based study. Ophthalmic Res. 2012; 49(1):25-9. DOI: 10.1159/000341735. View

15.

Vidovic T, Cerovski B, Jukic T . The appearance of pars planitis in multiple sclerosis. Coll Antropol. 2005; 29(1):203-6. View

16.

Biousse V, Trichet C, Bloch-Michel E, Roullet E . Multiple sclerosis associated with uveitis in two large clinic-based series. Neurology. 1999; 52(1):179-81. DOI: 10.1212/wnl.52.1.179. View

17.

Lim L, Silva D, Lo T, Pimentel R, Butzkueven H, Hall A . Uveitis in Patients with Multiple Sclerosis in Clinical Trials of Fingolimod: Incidence, Prevalence, and Impact on Disease Course. Ophthalmology. 2018; 126(3):438-444. DOI: 10.1016/j.ophtha.2018.10.013. View

18.

David O, Kovarik J, Schmouder R . Clinical pharmacokinetics of fingolimod. Clin Pharmacokinet. 2011; 51(1):15-28. DOI: 10.2165/11596550-000000000-00000. View

19.

McVerry B, Garcia J . Endothelial cell barrier regulation by sphingosine 1-phosphate. J Cell Biochem. 2004; 92(6):1075-85. DOI: 10.1002/jcb.20088. View

20.

Jouve L, Benrabah R, Heron E, Bodaghi B, Hoang P, Touitou V . Multiple Sclerosis-related Uveitis: Does MS Treatment Affect Uveitis Course?. Ocul Immunol Inflamm. 2016; 25(3):302-307. DOI: 10.3109/09273948.2015.1125508. View