Patients with relapsing-remitting multiple sclerosis (RRMS) demonstrated improved cognitive function 6 months after fingolimod initiation, according to the results from a prospective, controlled trial presented at the 2016 CMSC Annual Meeting in National Harbor, MD.

Forty to 65% of patients with MS demonstrate cognitive impairment, though some first line therapies have been associated with improvements in cognitive measures. With a lack of data on the impact of fingolimod, Professor Dr Serkan Ozakbas, of Dokuz Eylul University in Izmir, Turkey, and colleagues conducted a prospective, multicenter, blinded controlled trial in 96 patients with RRMS.

Adult RRMS patients (71 females, mean age 34.4 years) with an Expanded Disability Status Scale (EDSS) of 5.5 or less were initiated on fingolimod and compared to 98 healthy controls. Neurologic and cognitive assessments were performed at baseline and every 6 months over 2 years.

Improvements in cognition assessed the Symbol Digit Modality Test (SDMT) (39.25 vs 42.45, P=.021), the Brief Visuospatial Memory Test-Revised (BVMT-R) (24.35 vs 26.2, P=.017), and the California Verbal Learning Test-2 (CVLT-2) (48.3 vs 50.93, P=.012) were observed from baseline to 6 months.

The number of patients meeting criteria for cognitive impairment improved from baseline to follow-up at 6 months as measured by the SDMT (34 vs 22, P=.002), the CVLT-2 (36 vs 27), and the BVMT-R (33 vs 19). The patients were noted to be stable at subsequent follow-up evaluations through month 24.  

The authors highlight that the observed cognitive improvements in RRMS patients are the first “regarding effects of fingolimod in real life.”

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Ozakbas S, Cinar BP, Kosehasanogullari G, Yigit P.  Abstract CG35. Effects of Fingolimod on Cognitive Status in Patients with Multiple Sclerosis: Prospective, Controlled Trial. Presented at: CMSC Annual Meeting 2016. June 1-4, 2016; National Harbor, MD.