Author Topic: Thinner people may be at more risk w/Gilenya  (Read 148 times)

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Offline agate

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Thinner people may be at more risk w/Gilenya
« on: November 02, 2014, 03:39:52 pm »
This study is open-label and probably should be regarded as less dependable than some other kinds of studies, but the authors are maintaining that an underweight woman on Gilenya  might need especially careful monitoring because of a higher risk of lymphopenia.

From PubMed, November 2, 2014:

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Neurology. 2014 Oct 31.

Initial lymphocyte count and low BMI may affect fingolimod-induced lymphopenia

Warnke C1, Dehmel T1, Ramanujam R1, Holmen C1, Nordin N1, Wolfram K1, Leussink VI1, Hartung HP1, Olsson T1, Kieseier BC2.

Author information

1From the Department of Neurology (C.W., T.D., K.W., V.I.L., H.-P.H., B.C.K.), Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; and Department of Clinical Neuroscience (R.R., C.H., N.N., T.O.), Karolinska Institute, Stockholm, Sweden.

2From the Department of Neurology (C.W., T.D., K.W., V.I.L., H.-P.H., B.C.K.), Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; and Department of Clinical Neuroscience (R.R., C.H., N.N., T.O.), Karolinska Institute, Stockholm, Sweden. bernd.kieseier@uni-duesseldorf.de.

OBJECTIVE:

To assess whether pretreatment-lymphocyte counts, treatment before fingolimod, age, sex, or body mass index (BMI) affects the risk of fingolimod-induced lymphopenia in patients with relapsing-remitting multiple sclerosis (RRMS).

METHODS:

Data were obtained from a German multicenter, single-arm, open-label study of patients with RRMS treated with fingolimod, and findings were validated in an independent Swedish national pharmacovigilance study.

RESULTS:

Four hundred eighteen patients with RRMS from Germany and 438 patients from Sweden were included. A nadir ≤0.2 × 109 lymphocytes/L was reached in 15% (95% confidence interval [CI] 12%-17%) of all 856 patients. Patients with lower starting lymphocyte counts (below 1.6 × 109/L) and patients with BMI lower than 18.5 kg/m2 (women only) were at higher risk of developing lymphopenia with values ≤0.2 × 109/L in the combined analysis, increasing the risk in these subgroups to 26% (95% CI 20%-31%) or 46% (95% CI 23%-71%), respectively. In the German cohort, infection rates were similar in patients who developed severe lymphopenia and those who did not.

CONCLUSIONS:

Our findings suggest that patients with low baseline lymphocyte counts and underweight women in which fingolimod treatment will be initiated should possibly be monitored more closely.

PMID: 25361781

The abstract can be seen here.
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

Offline agate

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Re: Thinner people may be at more risk w/Gilenya
« Reply #1 on: December 27, 2014, 08:06:33 am »
More on this in MedPage Today, December 27, 2014:

http://www.medpagetoday.com/Neurology/MultipleSclerosis/49285?xid=nl_mpt_DHE_2014-12-27&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=ST&eun=g345846d0r&userid=345846&email=j-teller-11%40alumni.uchicago.edu&mu_id=5339616&utm_term=Daily

If this link isn't working for you, I'd appreciate it if you'd let me know.

This part of the article may be of particular interest:

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About 85% of MS patients have relapsing/remitting disease at the time of diagnosis, but a large percentage eventually develop the progressive form.

"About half of people with MS right now are living with the progressive form of the disease, and it is important to remember that there are no good disease-modifying therapies for progressive MS," [Bruce Bebo, Ph.D., National MS Society executive vice president of research] said.
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.