During the COVID-19 pandemic, concerns raised regarding the use of immunosuppressants in multiple sclerosis, even if current data do not support an increased risk of infection. Although fingolimod can be temporarily suspended during COVID-19, the benefit-risk balance of suspension can be challenging. Till now, no adverse events have been described after the resumption of fingolimod, following a previous discontinuation. We report the occurrence of atrioventricular block following fingolimod restart. Fingolimod acts on sphingosine-1-phosphate-axis, a pathway that is altered with COVID-19 and hypoxic conditions. Herein we discuss how these metabolic changes may have influenced fingolimod pharmacology leading to a cardiac event.
CITATION STYLE
Orrico, M., Nozzolillo, A., Gelibter, S., Sangalli, F., Preziosa, P., Filippi, M., & Moiola, L. (2021). Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19? Journal of Neurology, 268(11), 3975–3979. https://doi.org/10.1007/s00415-021-10556-z
Mendeley helps you to discover research relevant for your work.