Fingolimod reduces inflammatory activity in multiple sclerosis (MS) by acting as a functional antagonist of sphingosine 1-phosphate (S1P) receptors. It has been suggested that S1P might also contribute to the antiatherogenic effect of high-density lipoprotein (HDL). We conducted a retrospective observational study using data of 72 MS patients from two Finnish hospital districts to find out whether lipid profiles change during treatment with fingolimod. A mixed-effects model with patient as a random effect was used to analyze lipid profile alterations. We found a statistically significant elevation in both total cholesterol (0.12 mmol/L per year) and HDL (0.04 mmol/L per year) during a median follow-up of 12 months, while low-density lipoprotein (LDL) and triglycerides remained unchanged. Since the mean elevation observed in both lipid values seems to be modest, we suggest that routine lipid profile monitoring is unnecessary during fingolimod treatment in MS patients without pre-existing cardiovascular comorbidities.

Graphical abstract

芬戈莫德通过充当 1-磷酸鞘氨醇 (S1P) 受体的功能性拮抗剂来降低多发性硬化症 (MS) 的炎症活动。有人提出 S1P 也可能有助于高密度脂蛋白 (HDL) 的抗动脉粥样硬化作用。我们使用来自芬兰两个医院区的 72 名 MS 患者的数据进行了一项回顾性观察研究，以了解在芬戈莫德治疗期间血脂谱是否发生变化。将患者作为随机效应的混合效应模型用于分析脂质分布改变。在 12 个月的中位随访期间，我们发现总胆固醇（每年 0.12 mmol/L）和 HDL（每年 0.04 mmol/L）均显着升高，而低密度脂蛋白 (LDL) 和甘油三酯保持不变.

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