Increased disease activity in a case of multiple sclerosis after switching treatment from fingolimod to natalizumab

Role of effector T cells in multiple sclerosis

“…Indeed, it has also been reported that tumefactive MS lesions appear after initiating the fingolimod treatment (76). Another important issue is marked by the exacerbation of MS and subsequent cessation of fingolimod therapy, suggesting a rebound-like worsening of the disease activity that has also been described previously (77,78). Although it remains unclear whether the paradoxical effects of fingolimod were related to the modulation of T cells, clinician should keep in mind these unexpected outcomes related to the MS treatment.…”