{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:11:43Z","timestamp":1789924303823,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T00:00:00Z","timestamp":1633996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Studies reporting the baseline determinants of cognitive performance and treatment effect on cognition in patients with multiple sclerosis (MS) are limited. We investigated the baseline correlates of cognition and the long\u2010term treatment effects of fingolimod 0.5\u00a0mg once daily on cognitive processing speed and attention in patients with relapsing\u2010remitting MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This post hoc analysis pooled data from the phase 3 FREEDOMS and FREEDOMS II trials (<jats:italic>N<\/jats:italic>\u00a0=\u00a01556). We assessed the correlation between baseline patient demographic and disease characteristics and baseline 3\u2010second Paced Auditory Serial Addition Test (PASAT\u20103) scores (Spearman's rank test) and the changes from baseline in PASAT\u20103 (mixed model repeated measures model) in the fingolimod and placebo (up to 24\u00a0months) or placebo\u2010fingolimod switched (from Month 24 up to 120\u00a0months) groups. Additionally, the predictive value of PASAT\u20103 score for future disease outcomes was assessed (Cox or logistic regression models).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the variables assessed, lower PASAT\u20103 score at baseline correlated with higher disease burden (total brain volume, T2 lesion volume, and Expanded Disability Status Scale score), longer disease duration and older age (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001 for all). Fingolimod significantly improved PASAT\u20103 scores from baseline versus placebo at 6 (1.3; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0007), 12 (1.1; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0044) and 24\u00a0months (1.1; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0028), with a sustained effect (overall treatment effect <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0012) up to 120\u00a0months. Improvements were seen regardless of baseline cognitive status (PASAT quartile). Baseline PASAT\u20103 score was predictive of both clinical and magnetic resonance imaging measures of disease activity at Month 24 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001 for all).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early fingolimod treatment may offer long\u2010term cognitive benefit in patients with relapsing\u2010remitting MS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15081","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T06:41:26Z","timestamp":1629873686000},"page":"4135-4145","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Baseline characteristics and effects of fingolimod on cognitive performance in patients with relapsing\u2010remitting multiple sclerosis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1128-7417","authenticated-orcid":false,"given":"Dawn W.","family":"Langdon","sequence":"first","affiliation":[{"name":"Department of Psychology Royal Holloway University of London  Egham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davorka","family":"Tomic","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris\u2010Katharina","family":"Penner","sequence":"additional","affiliation":[{"name":"Medical Faculty Department of Neurology Heinrich Heine University  D\u00fcsseldorf Germany"},{"name":"COGITO Center for Applied Neurocognition and Neuropsychological Research  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Neuropsychology and Behavioral Neurology Unit Division of Cognitive and Molecular Neuroscience University of Basel  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Cutter","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama  Birmingham AL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter A.","family":"H\u00e4ring","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Dahlke","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig","family":"Kappos","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) and MS Center, Neurology, Departments of Head, Spine and Neuromedicine and Clinical Research University Hospital and University of Basel  Spitalstrasse 2 Basel Schweiz 4031 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