Abstract
Fingolimod is currently approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of pediatric patients with relapsing-remitting multiple sclerosis (RRMS). However, transient asymptomatic bradycardia with treatment initiation has been reported in a small population of predisposed patients, which may be a result of short-term activation and internalization/desensitization of the G-protein-gated potassium channel IKACh on the atrial myocyte membrane. Asymptomatic bradycardia, with or without atrioventricular block, is generally self-limiting and has been reported within the first 6 h of administration of the first oral dose of fingolimod. Therefore, patients initiating fingolimod treatment are monitored for this initial period to identify any changes in their electrocardiogram and heart rate that may require further treatment. Here, we report a case of a 17-year-old female with RRMS who received her first fingolimod dose and showed asymptomatic bradycardia that resolved without treatment.
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The authors thank Nishad Parkar, PhD, of Springer Healthcare Communications for providing assistance in editing and styling the manuscript before submission.
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No funding was received for this study. Support for medical writing and manuscript preparation was funded by Novartis Farma SpA.
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Roberta Lanzillo recruited the patient, assigned treatment, and revised the clinical case. Martina Petruzzo was in charge of patient monitoring and drafted the manuscript for submission.
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Ethical approval was obtained from the ethics committee of the Federico II University Hospital in Naples. Informed consent to participate was obtained from legal guardians.
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Martina Petruzzo declares no conflict of interest. Roberta Lanzillo has received grants for public speaking and as an advisory board member from Biogen, TEVA, Roche, Novartis, and Merck.
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Petruzzo, M., Lanzillo, R. Asymptomatic bradycardia after first fingolimod dose in a pediatric patient with multiple sclerosis – a case report. Neurol Sci 42 (Suppl 1), 37–39 (2021). https://doi.org/10.1007/s10072-021-05086-5
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DOI: https://doi.org/10.1007/s10072-021-05086-5