Details

Autor(en) / Beteiligte

• Bernard-Valnet, Raphaël
• Pignolet, Béatrice
• Biotti, Damien
• Ciron, Jonathan
• Lafontan, Jean François
• Dumas, Hervé
• Bonneville, Fabrice
• Brassat, David

Titel

Unexpected high multiple sclerosis activity after switching from fingolimod to alemtuzumab

Ist Teil von

• Multiple sclerosis and related disorders, 2018-10, Vol.25, p.216-218

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• •Fingolimod withdrawal could be followed by severe relapse despite Alemtuzumab introduction.•Several immunological mechanisms could underlie this phenomenon including prolonged sequestration of activated lymphocyte and/or paradoxical effect of alemtuzumab.•This case highlights challenges in sequential use of immunotherapies in multiple sclerosis. Unexpected high disease activity (UHDA) after Fingolimod withdrawal has recently become a controversial concern for physicians. Here, we report the case of a patient with severe exacerbation of MS after switching from Fingolimod to Alemtuzumab treatment. This UHDA despite profound lymphopenia raised the question of the management of sequential use of biotherapies such as Fingolimod and Alemtuzumab in MS.