Cladribine to treat disease exacerbation after fingolimod discontinuation in progressive multiple sclerosis.

Rebound disease following cessation of disease modifying treatment ( DMT) has been reported in people with both relapsing and progressive multiple sclerosis (pw RMS, pw PMS) questioning strict separation between these two phenotypes. While licensed DMT is available for pw RMS to counter rebound disease, no such option exists for pw PMS. We report on a pw PMS who developed rebound disease, with 45 Gadolinium-enhancing lesions on T₁ weighted MRI brain, within 6 months after fingolimod 0.5 mg/day was stopped. Treatment with a short course of subcutaneous cladribine 60 mg led to effective suppression of inflammatory activity and partial recovery with no short-term safety issues or adverse events. [ABSTRACT FROM AUTHOR]