ArticleNeurology. Clinical practice2018
Effectiveness of alternative dose fingolimod for multiple sclerosis.
Open access · bronzeAbstract read
In one paragraph
Article in Neurology. Clinical practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.7field-weighted citation impact, top 17% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Impact of Age on Switching or Stopping Disease Modifying Therapies in Multiple Sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- De-escalation and Discontinuation of Disease-Modifying Therapies in Multiple Sclerosis.Current neurology and neuroscience reports · 2024Review
- Alternate dosing of fingolimod in relapsing-remitting multiple sclerosis: A systematic review.Current journal of neurology · 2023Article
- Fingolimod as a first- or second-line treatment in a mini-series of young Hellenic patients with adolescent-onset multiple sclerosis: focus on immunological data.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Clinical effectiveness of reduced fingolimod dose in relapsing remitting multiple sclerosis-a Portuguese cohort.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Observational
- Management of Idiopathic CNS inflammatory diseases during the COVID-19 pandemic: Perspectives and strategies for continuity of care from a South East Asian Center with limited resources.Multiple sclerosis and related disorders · 2020Article
- Druggable Sphingolipid Pathways: Experimental Models and Clinical Opportunities.Advances in experimental medicine and biology · 2020Review
- Managing Disease-Modifying Therapies and Breakthrough Activity in Multiple Sclerosis Patients During the COVID-19 Pandemic: Toward an Optimized Approach.Therapeutics and clinical risk management · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 10 institutions in 2 countries.
Erin E LongbrakeYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Daniel KantorYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Siddharama PawateYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Michael J BradshawYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Gloria von GeldernYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Salim ChahinYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Anne H CrossYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Becky J ParksYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Marc RiceYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Samia J KhouryYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Bassem YamoutYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Maya ZeineddineYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Shira Russell-GillerYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Ana Caminero-RodriguezYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Keith EdwardsYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Ellen LathiYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Danita VanderKoddeYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
William MeadorYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Regina BerkovichYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Lily GeYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Tamar E BaconYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
Ilya KisterYale University (EEL), New Haven, CT; Medical Partnership 4 MS (MP4MS) (DK), Coconut Creek, FL; Vanderbilt University (SP, MJB), Nashville, TN; University of Washington (GvG), Seattle; Washington University (SC, AHC, BJP), St. Louis, MO; MS Center of Tidewater (MR), Norfolk, VA; Nehme & Therese Tohme MS Center (SJK, BY, MZ), Beirut, Lebanon; RWJ Barnabas Health (SR-G, IK), West Orange, NJ; C/Fuentes Claras 1 (AC-R), Avila, Spain; MS Center of Northeastern NY (KE), Latham; Elliot Lewis Center for MS Care (EL), Wellesley, MA; Spectrum Health Medical Group (DV), Grand Rapids, MI; University of Alabama (WM), Birmingham; University of Southern California (RB), Los Angeles; and NYU Langone Health (LG, TEB, IK), New York, NY.
University of Southern California · USSaint Barnabas Medical Center · USVanderbilt University · USYale University · USCatholic University of Ávila · ESUniversity of Alabama at Birmingham · USUniversity of Washington · USMultiple Sclerosis Center Of Northeastern New York · USSpectrum Health · USTidewater Community College · US
Funding
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9MAbstract
backgroundFingolimod is a daily oral medication used to treat relapsing multiple sclerosis (MS). Clinicians often adopt less frequent dosing for patients with profound drug-induced lymphopenia or other adverse events. Data on the effectiveness of alternate dose fingolimod are limited.
methodsWe conducted a multicenter, retrospective, observational study at 14 sites and identified 170 patients with MS taking alternate doses of fingolimod for ≥1 month. Clinical and radiologic outcomes were collected and compared during daily and alternate fingolimod dosing.
resultsProfound lymphopenia (77%), liver function abnormalities (9%), and infections (7%) were the most common reasons for patients to switch to alternate fingolimod dosing. The median follow-up was 12 months on daily dose and 14 months on alternate dose. Most patients (64%) took fingolimod every other day during alternate dosing. Disease activity was similar on alternate dose compared to daily dose: annualized relapse rate was 0.1 on daily dose vs 0.2 on alternate dose (
conclusionsThese data support the clinical strategy of alternate dosing of fingolimod in patients with good disease control but profound lymphopenia or other adverse events while on daily dose. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with MS on daily dose fingolimod with adverse events, alternate dose fingolimod is associated with disease activity similar to daily dose fingolimod.
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