Ventricular tachycardia on chronic fingolimod treatment for multiple sclerosis

Castillo-Triviño, Tamara; Lopetegui, Itziar; Alarcón-Duque, Jose A.; Munáin, Adolfo López de; Olascoaga, Javier

doi:10.1136/jnnp-2014-310013

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…In addition to the above studies, several case reports have described cardiac complications in MS patients receiving fingolimod. One described a 37-year-old patient with a non-specific complaint of dizziness and asthenia who had a documented episode of ventricular tachycardia on Holter monitoring within the first month of fingolimod treatment [100]. Another case report described a 51-year-old patient who developed a Mobitz type I second-degree AV block during the initial 6-h monitoring period; she then went into a junctional tachycardia and later went back into a symptomatic Mobitz type I AV block with an HR nadir of 38 bpm that was treated with atropine [19].…”

Section: Fingolimodmentioning

confidence: 99%

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Findling

Hauer

Pezawas

et al. 2020

JCM

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Cardiac autonomic dysfunction (CAD) has been reported in patients with multiple sclerosis (MS). This systematic review summarizes the evidence for the types and prevalence of CAD in MS patients, as well as its association with MS type, disease characteristics, fatigue and immunotherapies used to treat MS. The analysis revealed that CAD is correlated with pathophysiological processes of MS, can trigger serious cardiovascular complications that may reduce life expectancy, and may have implications for treatment with immunotherapies, especially fingolimod. Numerous mainly small case-control or cohort studies have reported various measures of CAD (particularly heart rate variation) in MS patients, showing higher rates of abnormality versus controls. A smaller number of studies have reported on cardiac autonomic symptoms in MS, including orthostatic intolerance/dizziness in around 50% of patients. CAD also appears to be associated with disease duration and to be more common in progressive than relapsing-remitting MS. However, although a substantial evidence base suggests that assessing CAD in people with MS may be important, standardised methods to evaluate CAD in these patients have not yet been established. In addition, no studies have yet looked at whether treating CAD can reduce the burden of MS symptoms, disease activity or the rate of progression.

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Section: Fingolimodmentioning

confidence: 99%

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Findling

Hauer

Pezawas

et al. 2020

JCM

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“…Our patient was diagnosed with ventricular tachycardia secondary to fingolimod. This association has only been reported once previously 3. Ventricular tachycardia should be considered when fingolimod is used to treat multiple sclerosis.…”

Section: Introductionmentioning

confidence: 84%

“…One report of ventricular tachycardia was reported in a young patient with no previous cardiac history who presented with dizziness and headache, after which she was found to have monomorphic ventricular tachycardia 3. Premature ventricular complexes were noted to increase in frequency in another patient 12…”

Section: Discussionmentioning

confidence: 99%

Ventricular tachycardia after initiation of fingolimod

et al. 2017

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Fingolimod, a sphingosine-1-phosphate receptor modulator, is used for the treatment of relapsing-remitting multiple sclerosis. It is well known to cause bradyarrhythmias. We present a 63-year-old woman who was admitted to the hospital with sustained monomorphic ventricular tachycardia 2 weeks after fingolimod initiation. Further evaluation showed that the patient's ventricular tachycardia was most likely secondary to her medication. Medical practitioners need to be aware of such possible life-threatening side effects while using fingolimod.

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Neues aus der Immuntherapie bei Multipler Sklerose

2018

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The spectrum of therapeutic options for immunotherapy of multiple sclerosis is continuously broadening. After the approval of cladribine and ocrelizumab in Europe, two new drugs are now available with ocrelizumab being the first approved option for treatment of primary progressive multiple sclerosis; however, the increased use of highly effective therapies is accompanied by a rise in severe side effects. During recent months, special attention was paid to the new progressive multifocal leukoencephalopathy (PML) risk assessment in natalizumab-treated patients, cardiac side effects of fingolimod, cases of idiopathic thrombocytopenic purpura and listeria meningitis associated with alemtuzumab and cases of daclizumab-treated patients with liver failure or encephalitis. These case reports highlight the importance of careful monitoring of all patients treated with immunomodulatory therapies.

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Ventricular tachycardia on chronic fingolimod treatment for multiple sclerosis

Cited by 8 publications

References 5 publications

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Ventricular tachycardia after initiation of fingolimod

Neues aus der Immuntherapie bei Multipler Sklerose

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