В рамках исследования альтернатив лечению финголимода у пациентов с множественным склерозом была разработана инфекция вируса папилломы (ВПВ), связанная с генитальными финголимодами.
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Paybast Sepideh, Ashtari Fereshteh, Moghaddam Nahid Beladi, Poursadeghfard Maryam, Abutorabi Marzie, Nahayati Mohammad Ali, Shahmohammadi Sareh, Moghadasi Abdorreza Naser, Ebadi Zahra, Heidari Hora, Sahraian Mohammad Ali
Аннотация
Оригинал публикации
Investigating treatment alternatives for fingolimod in patients with multiple sclerosis developed refractory fingolimod-related genital Human Papilloma Virus (HPV) infection.
INTRODUCTION: Genital human papillomavirus (HPV) infection is a rare skin complication in patients with relapse-remitting multiples sclerosis (RRMS) treated with fingolimod. Herein, we aimed to report a case series of 23 MS patients who had to discontinue fingolimod due to persistent HPV infection.
MATERIALS AND METHODS: This retrospective case series was conducted between September 2023 to September 2024 in six MS centers in Iran to identify the outcome of HPV infection who discontinued fingolimod.
RESULTS: 23 patients with a mean age of 36.34 ± 6.90 -year-old. The majority of patients were female (78.3 %) with a mean disease duration of 3.83 ± 3.02 years, and a mean EDSS score of 1.26 ± 1.10 at the time of fingolimod initiation. Most patients (39.1%) were treatment naïve. They developed genital HPV infection after a mean 32.21± 25.15 months of using fingolimod. Most patients (78.3%) were affected by low risk HPV infection and received a mean 1.96± 1.43 cycles of cryotherapy. After a mean 14.30±11.05 months, all patients had to discontinue treatment, mainly switched to anti-CD20 agents (78.3%). The lesions were resolved after a mean 4.52± 3.11 months. In addition, except for two patients developing a rebound after fingolimod cessations, others were stable with no evidence of disease activity or progression over a one-year follow-up.
CONCLUSION: Our preliminary results revealed that anti-CD20s agents could be considered safe in patients treated with fingolimod who had to discontinue treatment due to persistent HPV infection. Larger studies are needed to warrant our data.