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- W1505209087 abstract "OBJECTIVE:T o detect bradyarrhythmias after first fingolimod dose, beyond the recommended first 6hours of electrocardiogram (ECG) monitoring, by doing a systematic ECG at 24 h. BACKGROUND: Fingolimod is a sphingosine 1-phosphate receptor agonist which, after phosphorylation, prevents T lymphocyte migration into central nervous system. Fingolimod cause a negative chronotropic effect on heart rate because of the receptors in the atrial myocytes. The maximum effects are observed in the first 4-5 hours after the first dose, but they are transient likely to the receptor desensitization. No adverse cardiac events have been reported beyond 24 hours DESIGN/METHODS: Patients diagnosed with relapsing-remitting multiple sclerosis (RRMS) were clinically and ECG monitored at baseline, at 6 hours, and, additionally, at 24 hours after first fingolimod dose RESULTS: We performed ECG monitoring in 18 out of 23 patients (78.2%) that received a first fingolimod dose. The mean age was 36.7 years and 70.6% were female. All patients had been treated previously with immunomodulators (58.8%) or natalizumab (41.2%). The mean time between RRMS diagnosis and the beginning of fingolimod treatment was 7.5 years. Only one patient reported symptomatic bradycardia. Other adverse effects were headache, diarrhea and nausea.The baseline ECG (in 18 patients) showed normal results in 14 cases (77.8%), incomplete right bundle branch block (IRBBB) in 3 cases (17.3%) and left posterior fascicular block (LPFB) in one patient (5.8%). The ECG recording was done at 6-hours in 9 patients and showed abnormalities in 4 (44.4%): 2 with sinus block, 1 with first degree atrioventricular block, 1 with IRBBB + LPFB. The remaining patients showed no changes compared to baseline. ECG recording was done at 24 hours in 15 patients, and 3 patients had abnormalities (20%): 1 with IRBBB, 1 with IRBBB + LPFB and 1 with sinus block. CONCLUSIONS: Although asymptomatic ECG changes were observed at 6 (44%) and 24 hours (20%) after first dose of fingolimod, we observed no clinical or ECG effects requiring fingolimod discontinuation. Disclosure: Dr. Palazon has nothing to disclose. Dr. Carreon has nothing to disclose. Dr. Hernandez Clares has nothing to disclose. Dr. Jimenez has nothing to disclose. Dr. Salgado has nothing to disclose. Dr. Andreu has nothing to disclose. Dr. Martin has nothing to disclose. Dr. Meca Lallana has nothing to disclose." @default.
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- W1505209087 date "2014-04-08" @default.
- W1505209087 modified "2023-09-26" @default.
- W1505209087 title "Electrocardiogram Monitoring After the First Fingolimod Doses (P2.219)" @default.
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