6-Month Effects of Fingolimod on Indexes of Cardiovascular Autonomic Control in Multiple Sclerosis

Fingolimod, the first oral agent for treatment of multiple sclerosis (MS), exerts its main action through the engagement of sfingosine-1-phosphate receptors (S1Pr)(1) at the lymphocyte level. However, S1Pr are also expressed in the atrial myocytes and endothelial cells, and their activation may frequently cause a nonharmful bradycardia following the first dose. The drug is generally well tolerated, although some cardiovascular adverse effects have been reported, including first- or second-degree atrioventricular blocks(1) and a moderate reduction in the left ventricular systolic function(2). In a very limited number of patients, major cardiovascular events also have been signaled(1). The influence of fingolimod treatment on the autonomic cardiac control over time is still not fully clarified. In this observational longitudinal study, we investigated the effect of fingolimod on the sympathetic and parasympathetic heart control and on the arterial baroreflex function after 6 months of treatment.

Source: Journal of the American College of Cardiology - October 25, 2016 Category: Cardiology Source Type: research