Skip to main content
Log in

Fingolimod: A Review of Its Use in Relapsing-Remitting Multiple Sclerosis

  • Adis Drug Evaluation
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

Fingolimod (Gilenya®) is an orally administered disease modifying agent (DMA) for use in relapsing-remitting multiple sclerosis (RRMS). In placebo-controlled trials in patients with RRMS with active disease, fingolimod 0.5 mg/day significantly reduced the annualized relapse rate (ARR) by approximately one-half over 2-year trial periods. It also significantly increased the proportion of patients with no disability progression, reduced deterioration from baseline in the Extended Disability Status Scale score and reduced MRI markers of disease progression (new/newly enlarging brain lesions and percentage change in brain volume). In a 12-month, comparison with intramuscular interferon β-1a (IFNβ- 1a) 30 μg/week, the ARR in fingolimod 0.5 mg/day recipients was significantly lower than in IFNβ-1a recipients by one-half; fingolimod recipients also had significantly lower MRI markers of disease progression. In extensions to the pivotal clinical trials, fingolimod exposure for up to 4 years was associated with low relapse rates and continuing benefits in terms of disability and disease progression. In clinical trials, adverse events in fingolimod recipients were generally mild to moderate in severity. In the pivotal placebo-controlled trial, serious adverse events occurred in similar proportions of fingolimod 0.5 mg/day and placebo recipients. First-dose bradycardia and atrioventricular block, which are generally asymptomatic, were clinically important adverse events associated with fingolimod in placebo-controlled trials. The risk for serious cardiovascular adverse events at the approved fingolimod dosage appears to be low in patients without pre-existing cardiac conditions. Fingolimod is an efficacious therapy for RRMS that reduces relapses, disability progression, new brain lesions and loss of brain volume. It has an acceptable tolerability profile and provides a useful alternative treatment in patients with RRMS who have responded poorly to other DMAs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. World Health Organization. Atlas: multiple sclerosis resources in the world. 2008. http://www.who.int/mental_health/neurology/Atlas_MS_WEB.pdf. Accessed 27 May 2014.

  2. Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372(9648):1502–17.

    Article  CAS  PubMed  Google Scholar 

  3. Tremlett H, Zhao Y, Rieckmann P, et al. New perspectives in the natural history of multiple sclerosis. Neurology. 2010;74(24):2005–15.

    Google Scholar 

  4. Capkun-Niggli G, Nordstrom B, Lahoz R, et al. Mortality and morbidity in patients with multiple sclerosis compared with the general population: a retrospective analysis using the US Department of Defense database (abstract). 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis; 2–5 October 2013; Copenhagen.

  5. Confavreux C, Vukusic S. Age at disability milestones in multiple sclerosis. Brain. 2006;129(3):595–605.

    Article  PubMed  Google Scholar 

  6. Hohlfeld R, Barkhof F, Polman C. Future clinical challenges in multiple sclerosis: relevance to sphingosine 1-phosphate receptor modulator therapy. Neurology. 2011;76(8 Suppl 3):S28–37.

    Article  CAS  PubMed  Google Scholar 

  7. Ali R, Nicholas RS-J, Muraro PA. Drugs in development for relapsing multiple sclerosis. Drugs. 2013;73(7):625–50.

    Article  CAS  PubMed  Google Scholar 

  8. Gold R. Oral therapies for multiple sclerosis: a review of agents in phase III development or recently approved. CNS Drugs. 2011;25(1):37–52.

    Article  CAS  PubMed  Google Scholar 

  9. European Medicines Agency. Gilenya 0.5 mg hard capsules; summary of product characteristics. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002202/WC500104528.pdf. Accessed 27 May 2014.

  10. Novartis Pharmaceuticals Corporation. GILENYA (fingolimod) capsules (US prescribing information). 2012. http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/022527s008lbl.pdf. Accessed 27 May 2014.

  11. European Medicines Agency. Gilenya (fingolimod): summary of opinion (post authorisation). 2014. http://www.ema.europa.eu/docs/en_GB/document_library/Summary_of_opinion/human/002202/WC500165660.pdf. Accessed 28 May 2014.

  12. Mehling M, Johnson TA, Antel J, et al. Clinical immunology of the sphingosine 1-phosphate receptor modulator fingolimod (FTY720) in multiple sclerosis. Neurology. 2011;76(8 Suppl 3):S20–7.

    Article  CAS  PubMed  Google Scholar 

  13. David OJ, Kovarik JM, Schmouder RL. Clinical pharmacokinetics of fingolimod. Clin Pharmacokinet. 2012;51(1):15–28.

    Article  CAS  PubMed  Google Scholar 

  14. Scott LJ. Fingolimod: a review of its use in the management of relapsing-remitting multiple sclerosis. CNS Drugs. 2011;25(8):673–98.

    Article  CAS  PubMed  Google Scholar 

  15. Fyrst H, Saba JD. An update on sphingosine-1-phosphate and other sphingolipid mediators. Nat Chem Biol. 2010;6(7):489–97.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Mehling M, Brinkmann V, Antel J, et al. FTY720 therapy exerts differential effects on T cell subsets in multiple sclerosis. Neurology. 2008;71(16):1261–7.

    Article  CAS  PubMed  Google Scholar 

  17. Francis G, Kappos L, O’Connor P, et al. Temporal profile of lymphocyte counts and relationship with infections with fingolimod therapy. Mult Scler. 2014;20(4):471–80.

    Article  CAS  PubMed  Google Scholar 

  18. Mehling M, Lindberg R, Raulf F, et al. Th17 central memory T cells are reduced by FTY720 in patients with multiple sclerosis. Neurology. 2010;75(5):403–10.

    Article  CAS  PubMed  Google Scholar 

  19. Mehling M, Hilbert P, Fritz S, et al. Antigen-specific adaptive immune responses in fingolimod-treated multiple sclerosis patients. Ann Neurol. 2011;69(2):408–13.

    Article  CAS  PubMed  Google Scholar 

  20. Kowarik MC, Pellkofer HL, Cepok S, et al. Differential effects of fingolimod (FTY720) on immune cells in the CSF and blood of patients with MS. Neurology. 2011;76(14):1214–21.

    Article  CAS  PubMed  Google Scholar 

  21. Groves A, Kihara Y, Chun J. Fingolimod: direct CNS effects of sphingosine 1-phosphate (S1P) receptor modulation and implications in multiple sclerosis therapy. J Neurol Sci. 2013;328(1–2):9–18.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Choi JW, Gardell SE, Herr DR, et al. FTY720 (fingolimod) efficacy in an animal model of multiple sclerosis requires astrocyte sphingosine 1-phosphate receptor 1 (S1P1) modulation. Proc Natl Acad Sci US A. 2011;108(2):751–6.

    Article  CAS  Google Scholar 

  23. Van Doorn R, Van Horssen J, Verzijl D, et al. Sphingosine 1-phosphate receptor 1 and 3 are upregulated in multiple sclerosis lesions. Glia. 2010;58(12):1465–76.

    PubMed  Google Scholar 

  24. Kovarik JM, Lu M, Riviere GJ, et al. The effect on heart rate of combining single-dose fingolimod with steady-state atenolol or diltiazem in healthy subjects. Eur J Clin Pharmacol. 2008;64(5):457–63.

    Article  CAS  PubMed  Google Scholar 

  25. Kovarik JM, Slade A, Riviere GJ, et al. The ability of atropine to prevent and reverse the negative chronotropic effect of fingolimod in healthy subjects. Br J Clin Pharmacol. 2008;66(2):199–206.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Boulton C, David OJ, Meiser K, et al. Tolerability and pulmonary effects during treatment initiation of once-daily fingolimod in subjects with moderate asthma. Clin Pharmacol Drug Devel. 2013;2(1):2–10.

    Article  Google Scholar 

  27. Nolan R, Gelfand JM, Green AJ. Fingolimod treatment in multiple sclerosis leads to increased macular volume. Neurology. 2013;80(2):139–44.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Ocwieja M, Meiser K, David OJ, et al. Effect of fingolimod (FTY720) on cerebral blood flow, platelet function and macular thickness in healthy volunteers. Br J Clin Pharmacol. 2014. doi:10.1111/bcp.12454.

  29. Wu K, Mercier F, David OJ, et al. Population pharmacokinetics of fingolimod phosphate in healthy participants. J Clin Pharmacol. 2012;52(7):1054–68.

    Article  CAS  PubMed  Google Scholar 

  30. Kovarik JM, Schmouder R, Barilla D, et al. Single-dose FTY720 pharmacokinetics, food effect, and pharmacological responses in healthy subjects. Br J Clin Pharmacol. 2004;57(5):586–91.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Kovarik JM, Slade A, Voss B, et al. Ethnic sensitivity study of fingolimod in white and Asian subjects. Int J Clin Pharmacol Ther. 2007;45(2):98–109.

    Article  CAS  PubMed  Google Scholar 

  32. Kovarik JM, Schmouder RL, Serra D, et al. FTY720 pharmacokinetics in mild to moderate hepatic impairment. J Clin Pharmacol. 2005;45(4):446–52.

    Article  CAS  PubMed  Google Scholar 

  33. Kovarik JM, Schmouder RL, Hartmann S, et al. Fingolimod (FTY720) in severe hepatic impairment: pharmacokinetics and relationship to markers of liver function. J Clin Pharmacol. 2006;46(2):149–56.

    Article  CAS  PubMed  Google Scholar 

  34. David OJ, Ocwieja M, Meiser K, et al. Pharmacokinetics of fingolimod (FTY720) and a combined oral contraceptive coadministered in healthy women: drug-drug interaction study results. Int J Clin Pharmacol Ther. 2012;50(8):540–4.

    Article  CAS  PubMed  Google Scholar 

  35. Kappos L, Antel J, Comi G, et al. Oral fingolimod (FTY720) for relapsing multiple sclerosis. N Engl J Med. 2006;355(11):1124–40.

    Article  CAS  PubMed  Google Scholar 

  36. Saida T, Kikuchi S, Itoyama Y, et al. A randomized, controlled trial of fingolimod (FTY720) in Japanese patients with multiple sclerosis. Mult Scler. 2012;18(9):1269–77.

    Article  CAS  PubMed  Google Scholar 

  37. Kappos L, Radue E-W, O’Connor P, et al. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med. 2010;362(5):387–401.

    Article  CAS  PubMed  Google Scholar 

  38. Calabresi PA, Radue E-W, Goodin D, et al. Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2014;13(6):545–56.

    Article  CAS  PubMed  Google Scholar 

  39. Cohen JA, Barkhof F, Comi G, et al. Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med. 2010;362(5):402–15.

    Article  CAS  PubMed  Google Scholar 

  40. O’Connor P, Polman C, Hohlfeld R, et al. Phase III FREEDOMS study extension: long-term safety of fingolimod (FTY720) in relapsing-remitting multiple sclerosis [abstract no. P 523]. 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis; 10–13 October 2012; Lyon.

  41. Khatri B, Barkhof F, Comi G, et al. Comparison of fingolimod with interferon beta-1a in relapsing-remitting multiple sclerosis: a randomised extension of the TRANSFORMS study. Lancet Neurol. 2011;10(6):520–9.

    Article  CAS  PubMed  Google Scholar 

  42. Kappos L, Radue EW, O’Connor P, et al. Phase 3 FREEDOMS study extension: fingolimod (FTY720) efficacy in patients with relapsing-remitting multiple sclerosis receiving continuous or placebo- fingolimod switched therapy for up to 4 years [abstract no. P979, with poster]. 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis; 10–13 October 2012; Lyon.

  43. Radue E-W, O’Connor P, Polman CH, et al. Impact of fingolimod therapy on magnetic resonance imaging outcomes in patients with multiple sclerosis. Arch Neurol. 2012;69(10):1259–69.

    Article  PubMed  Google Scholar 

  44. Devonshire V, Havrdova E, Radue EW, et al. Relapse and disability outcomes in patients with multiple sclerosis treated with fingolimod: subgroup analyses of the double-blind, randomised, placebo-controlled FREEDOMS study. [Erratum appears in Lancet Neurol. 2012;11(8):658]. Lancet Neurol. 2012;11(5):420–8.

    Article  CAS  PubMed  Google Scholar 

  45. Kremenchutzky M, O’Connor P, Hohlfeld R, et al. Impact of prior treatment status and reasons for discontinuation on the efficacy and safety of fingolimod: subgroup analyses of the Fingolimod Research Evaluating Effects of Daily Oral Therapy in Multiple Sclerosis (FREEDOMS) study. Mult Scler Relat Dis. 2014;3:341–9.

    Article  Google Scholar 

  46. Bergval N, Sfikas N, Chin P, et al. Efficacy of fingolimod in pre-treated multiple sclerosis patients with disease activity: pooled analysis of FREEDOMS and FREEDOMS II [abstract no. P3.174]. 66th Annual Meeting of the American Association of Neurology; 26 April-3 May 2014; Philadelphia (PA).

  47. Agius M, Meng X, Chin P, et al. Fingolimod therapy in early multiple sclerosis: an efficacy analysis of the TRANSFORMS and FREEDOMS studies by time since first symptom. CNS Neurosci Ther. 2014;20(5):446–51.

    Article  CAS  PubMed  Google Scholar 

  48. Khatri B, Barkhof F, Comi G, et al. Fingolimod treatment increases the proportion of patients who are free from disease activity in multiple sclerosis compared to IFN-B1A: Results from a phase 3, active-controlled study (TRANSFORMS). 64th American Academy of Neurology Annual Meeting; 2012; New Orleans (LO).

  49. Cohen JA, Barkhof F, Comi G, et al. Fingolimod versus intramuscular interferon in patient subgroups from TRANSFORMS. J Neurol. 2013;260(8):2023–32.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Khatri BO, Pelletier J, Kappos L. Effect of prior treatment status and reasons for discontinuation on the efficacy and safety of fingolimod vs. interferon beta-1a intramuscular: subgroup analyses of the Trial Assessing Injectable Interferon vs. Fingolimod Oral in Relapsing-Remitting Multiple Sclerosis (TRANSFORMS). Mult Scler Relat Dis. 2014;3(3):355–63.

    Article  Google Scholar 

  51. Barkhof F, de Jong R, Sfikas N, et al. The influence of patient demographics, disease characteristics and treatment on brain volume loss in Trial Assessing Injectable Interferon vs FTY720 Oral in Relapsing-Remitting Multiple Sclerosis (TRANSFORMS), a phase 3 study of fingolimod in multiple sclerosis. Mult Scler. 2014. doi:10.1177/1352458514532317.

    PubMed Central  Google Scholar 

  52. Vollmer T, Jeffery D, Goodin D, et al. Long-term safety of fingolimod in patients with relapsing-remitting multiple sclerosis: results from phase 3 FREEDOMS II extension study [abstract no. P01.165]. Neurology. 2013;80(1).

  53. Kappos L, Cohen J, Collins W, et al. Fingolimod in relapsing multiple sclerosis: an integrated analysis of safety findings. Mult Scler Relat Dis. 2014;3(6):494–504.

    Article  Google Scholar 

  54. Gold R, Comi G, Palace J, et al. Assessment of cardiac safety during fingolimod treatment initiation in a real-world relapsing multiple sclerosis population: a phase 3b, open-label study. J Neurol. 2014;261(2):267–76.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  55. DiMarco JP, O’Connor P, Cohen JA, et al. First-dose effect of fingolimod: pooled safety data from three phase 3 studies. Mult Scler Rel Dis. 2014. doi:10.1016/j.msard.2014.05.005.

  56. Zarbin MA, Jampol LM, Jager RD, et al. Ophthalmic evaluations in clinical studies of fingolimod (FTY720) in multiple sclerosis. Ophthalmology. 2013;120(7):1432–9.

    Article  PubMed  Google Scholar 

  57. Francis G, Dahlke F, Von Rosenstiel P, et al. Assessment of potential risk of progressive multifocal leukoencephalopathy with fingolimod compared with that of natalizumab [abstract no. P01.160]. 65th Annual Meeting of the American Academy of Neurology; 16–23 March 2013; San Diego (CA).

  58. US Food and Drug Administration. FDA drug safety communication: FDA investigating rare brain infection in patient taking Gilenya (fingolimod). http://www.fda.gov/Drugs/DrugSafety/ucm366529.htm. Accessed 27 May 2014.

  59. European Medicines Agency. European Medicines Agency gives new advice to better manage risk of adverse effects on the heart with Gilenya [media release]. 10 May 2012. http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2012/04/WC500125690.pdf.

  60. Ontaneda D, Hara-Cleaver C, Rudick RA, et al. Early tolerability and safety of fingolimod in clinical practice. J Neurol Sci. 2012;323(1–2):167–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  61. Schurmann P, Basra S, Awar OG, et al. Abnormal rhythms in patients without known cardiac disease after a first dose of fingolimod. Mult Scler Relat Dis. 2014;3(3):408–12.

    Article  Google Scholar 

  62. US Food and Drug Administration. FDA Drug Safety Communication: revised recommendations for cardiovascular monitoring and use of multiple sclerosis drug Gilenya (fingolimod). 2012. http://www.fda.gov/drugs/drugsafety/ucm303192.htm. Accessed 27 May 2014.

  63. McCormack PL. Natalizumab: a review of its use in the management of relapsing-remitting multiple sclerosis. Drugs. 2013;73(13):1463–81.

    Article  CAS  PubMed  Google Scholar 

  64. Agashivala NV, Dastani HB, Carlton R, et al. Cost-effectiveness of fingolimod in treating patients with relapsing-remitting multiple sclerosis. Am J Pharm Benefits. 2011;3(6):320–8.

  65. Lee S, Baxter DC, Limone B, et al. Cost-effectiveness of fingolimod versus interferon beta-1a for relapsing remitting multiple sclerosis in the United States. J Med Econ. 2012;15(6):1088–96.

    Article  PubMed  Google Scholar 

  66. O’Day K, Meyer K, Miller RM, et al. Cost-effectiveness of natalizumab versus fingolimod for the treatment of relapsing multiple sclerosis. J Med Econ. 2011;14(5):617–27.

    Article  PubMed  Google Scholar 

  67. Bergvall N, Tambour M, Henriksson F, et al. Cost-minimization analysis of fingolimod compared with natalizumab for the treatment of relapsing-remitting multiple sclerosis in Sweden. J Med Econ. 2013;16(3):349–57.

    Article  PubMed  Google Scholar 

  68. Heisen M, Treur MJ, van der Hel WS, et al. Fingolimod reduces direct medical costs compared to natalizumab in patients with relapsing-remitting multiple sclerosis in The Netherlands. J Med Econ. 2012;15(6):1149–58.

    Article  CAS  PubMed  Google Scholar 

  69. Calabresi PA. Diagnosis and management of multiple sclerosis. Am Fam Physician. 2004;70(10):1935–44.

    PubMed  Google Scholar 

  70. Association of British Neurologists. Revised (2009) Association of British Neurologists guidelines for prescribing in multiple sclerosis. http://theabn.org/abn/userfiles/file/ABN_MS_Guidelines_2009_Final(1).pdf. Accessed 27 May 2014.

  71. Goodin DS, Frohman EM, Garmany GP Jr, et al. Disease modifying therapies for multiple sclerosis: report of the Therapeutics and Technology Assessment Committtee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines. Neurology. 2002;58(2):169–78.

    Article  CAS  PubMed  Google Scholar 

  72. National Institute for Clinical Excellence. Multiple sclerosis: management of multiple sclerosis in primary and secondary care. 2003. http://www.nice.org.uk/nicemedia/live/10930/29199/29199.pdf. Accessed 27 May 2014.

  73. EMD Serono, Inc. Novantrone® (mitoxantrone for injection concentrate): US prescribing information. 2012. http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019297s035lbl.pdf. Accessed 27 May 2014.

  74. Biogen Idec, Inc. Tysabri® (natalizumab) injection for intravenous use: US prescribing information. 2014. http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/125104s813lbl.pdf. Accessed 27 May 2013.

  75. Sprenger T, Kappos L. Alemtuzumab for multiple sclerosis: who to treat and what to treat? Lancet. 2012;380(9856):1795–7.

    Article  PubMed  Google Scholar 

  76. European Medicines Agency. LEMTRADA 12 mg concentrate for solution for infusion: summary of product characteristics. 2014. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/003718/WC500150521.pdf. Accessed 27 May 2013.

  77. Genzyme. Genzyme’s LEMTRADA™ (alemtuzumab) application for MS accepted for review by the FDA [media release]. 28 January 2013. http://news.genzyme.com/press-release/genzymes_lemtrada-alemtuzumab-application-ms-accepted-review-fda.

  78. Goodin DS, Cohen BA, O’Connor P, et al. Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommitttee of the American Academy of Neurology. Neurology. 2008;71(9):766–73.

    Article  CAS  PubMed  Google Scholar 

  79. Genzyme. Aubagio (teriflunomide) tablets for oral administration. 2012. http://products.sanofi.us/aubagio/aubagio.pdf. Accessed 27 May 2014.

  80. Telfer NR, Colver GB, Morton CA. Guidelines for the management of basal cell carcinoma. Br J Dermatol. 2008;159(1):35–48.

    Article  CAS  PubMed  Google Scholar 

  81. National Institute for Clinical Excellence. Fingolimod for the treatment of highly active relapsing-remitting multiple sclerosis. 2013. http://publications.nice.org.uk/. Accessed 27 May 2014.

  82. Cascione M, Wynn D, Barbato LM, et al. Randomized, open-label study to evaluate patient-reported outcomes with fingolimod after changing from prior disease-modifying therapy for relapsing multiple sclerosis: EPOC study rationale and design. J Med Econ. 2013;16(7):859–65.

    Article  PubMed  Google Scholar 

  83. Miller D, Cree B, Dalton C, et al. Study design and baseline characteristics of the INFORMS study: fingolimod in patients with primary multiple sclerosis. 65th American Academy of Neurology Annual Meeting; 2013; San Diego (CA).

Download references

Disclosure

The preparation of this review was not supported by any external funding. Mark Sanford is a salaried employee of Springer/Adis. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark Sanford.

Additional information

The manuscript was reviewed by: M.S. Freedman, Multiple Sclerosis Research Clinic, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada; T. Masterman, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; S.A. Sadiq, Tisch Multiple Sclerosis Research Center of New York, New York, NY, USA; Y. Winter, Department of Neurology, Philipps University, Marburg, Germany.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sanford, M. Fingolimod: A Review of Its Use in Relapsing-Remitting Multiple Sclerosis. Drugs 74, 1411–1433 (2014). https://doi.org/10.1007/s40265-014-0264-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40265-014-0264-y

Keywords

Navigation