Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?

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...

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Autores principales: Orrico, Mario, Nozzolillo, Agostino, Gelibter, Stefano, Sangalli, Francesca, Preziosa, Paolo, Filippi, Massimo, Moiola, Lucia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Original Communication
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045443/
https://www.ncbi.nlm.nih.gov/pubmed/33852086
http://dx.doi.org/10.1007/s00415-021-10556-z
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author Orrico, Mario
Nozzolillo, Agostino
Gelibter, Stefano
Sangalli, Francesca
Preziosa, Paolo
Filippi, Massimo
Moiola, Lucia
author_facet Orrico, Mario
Nozzolillo, Agostino
Gelibter, Stefano
Sangalli, Francesca
Preziosa, Paolo
Filippi, Massimo
Moiola, Lucia
author_sort Orrico, Mario
collection PubMed
description 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.
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spelling pubmed-80454432021-04-15 Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19? Orrico, Mario Nozzolillo, Agostino Gelibter, Stefano Sangalli, Francesca Preziosa, Paolo Filippi, Massimo Moiola, Lucia J Neurol Original Communication 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. Springer Berlin Heidelberg 2021-04-14 2021 /pmc/articles/PMC8045443/ /pubmed/33852086 http://dx.doi.org/10.1007/s00415-021-10556-z Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Communication
Orrico, Mario
Nozzolillo, Agostino
Gelibter, Stefano
Sangalli, Francesca
Preziosa, Paolo
Filippi, Massimo
Moiola, Lucia
Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
title Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
title_full Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
title_fullStr Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
title_full_unstemmed Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
title_short Atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to COVID-19?
title_sort atrioventricular block after fingolimod resumption: a consequence of sphingosine-1-phosphate axis alteration due to covid-19?
topic Original Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045443/
https://www.ncbi.nlm.nih.gov/pubmed/33852086
http://dx.doi.org/10.1007/s00415-021-10556-z
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