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Medical Author:

Fernando Dangond, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Fingolimod (Gilenya®): Fingolimod (Gilenya®) is a daily oral medication to treat MS that was approved by the US FDA in September 2010 as the first oral medication to treat MS. Although the exact mechanism of action of fingolimod is unclear, it appears to work by reducing the number of lymphocytes (a type of white blood cell that is important for immunity and the inflammation process) in the blood. Fingolimod is taken daily in capsule form. It is not a cure for MS, but it has been shown to decrease the number of MS flares and slow down the development of physical disability caused by MS. Like many injectable therapies for MS, the long-term safety of fingolimod is unknown. The most common side effects of fingolimod are headache, flu, diarrhea, back pain, elevations of liver enzymes in the blood, and cough. Other side effects are also possible including eye problems, so those taking this drug should have regular ophthalmologic evaluations.

Plasmapheresis (plasma exchange): This therapy is sometimes attempted for severe attacks that do not respond to corticosteroids. This therapy is expensive, not FDA approved for multiple sclerosis, and its efficacy is controversial.

IV immune globulin (IVIG): Although not FDA approved for multiple sclerosis, some studies have suggested that IVIG can reduce the rate of a second attack when IVIG was administered over 6 weeks following a first attack. Other researchers found no benefit when given to patients who had multiple sclerosis for at least 3 years. Yet others have studied IVIG when given on a regular monthly schedule and found a small but significant benefit of improving clinical disabilities and fewer relapses.