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Tolerability and Pulmonary Pharmacodynamic Effects During Treatment Initiation of Once‐Daily Oral Fingolimod in Subjects With Moderate Asthma
Author(s) -
Boulton Craig,
David Olivier J.,
Meiser Karin,
Schmouder Robert
Publication year - 2013
Publication title -
clinical pharmacology in drug development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.711
H-Index - 22
eISSN - 2160-7648
pISSN - 2160-763X
DOI - 10.1002/cpdd.4
Subject(s) - medicine , tolerability , pharmacodynamics , asthma , fingolimod , anesthesia , pharmacology , pharmacokinetics , adverse effect , multiple sclerosis , psychiatry
Abstract Fingolimod, a first‐in‐class sphingosine 1‐phosphate receptor modulator, is the first approved oral therapy for relapsing multiple sclerosis (MS). While treatment initiation of clinical dose of fingolimod (0.5 mg) does not affect pulmonary function, supra‐therapeutic doses (≥5.0 mg) increased airway resistance. The aim of this double‐blind, placebo‐controlled, parallel group, 10‐day study was to measure the effect of fingolimod on pulmonary function in otherwise healthy patients with moderate asthma. Subjects (n = 36) were randomized into four cohorts that received either fingolimod 0.5, 1.25, 2.5 mg, or placebo once daily for 10 days. Subjects in placebo and fingolimod 0.5 mg groups did not differ in FEV 1 AUEC 0–6 h , FEF 25–75% AUEC 0–6 h , or in short‐acting beta (β) 2 agonists (SABA, rescue bronchodilator) use. Subjects on higher doses of fingolimod showed a mild reduction in FEV 1 AUEC 0–6 h and FEF 25–75% AUEC 0–6 h and a significant sixfold increase in SABA use versus placebo. One subject had moderately severe, acute exacerbation of asthma after receiving the first dose of fingolimod 1.25 mg that quickly responded to inhaled SABA. The observed safety profile was consistent with previous reports. These results provide reassurance that moderately asthmatic MS individuals can start on fingolimod 0.5 mg therapy with minimal effects on pulmonary function and SABA use.