{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:26:50Z","timestamp":1787909210184,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with multiple sclerosis (MS) who discontinue fingolimod might present with rebound activity. The reasons for the development of rebound have been identified, but there are limited data on the long\u2010term clinical outcomes of these patients. This study aimed to compare the long\u2010term outcomes of patients with MS with and without rebound activity after fingolimod discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 31 patients who discontinued fingolimod for various reasons with a minimum follow\u2010up of 5\u2009years were included in the study. Of these, 10 were assigned to the rebound group and 21 to the non\u2010rebound group. Clinical and demographic data and 5\u2010year clinical outcomes of both groups were prospectively examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At fingolimod initiation, there were no significant differences in age, disease duration, and Expanded Disability Status Scale (EDSS) score. The annualized relapse rate (ARR) was significantly higher in the rebound group than in the non\u2010rebound group before the fingolimod treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). In the rebound group, EDSS scores 2\u2009months after rebound treatment and at the 5\u2010year follow\u2010up were not significantly different than before fingolimod initiation (<jats:italic>p<\/jats:italic>\u2009=\u20090.14 and <jats:italic>p<\/jats:italic>\u2009=\u20090.46, respectively). The last recorded EDSS was significantly higher in the non\u2010rebound group than in the rebound group (3.6\u2009\u00b1\u20092.3 vs. 2.15\u2009\u00b1\u20091.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.045). At the last follow\u2010up, one patient was diagnosed with secondary progressive multiple sclerosis in the rebound group (10%), and 11 patients were in the non\u2010rebound group (52.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When rebound activity is well\u2010monitored and treated after fingolimod discontinuation, no overall EDSS change is expected in the long\u2010term follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15913","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T17:09:56Z","timestamp":1686416996000},"page":"2745-2751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of multiple sclerosis patients with or without rebound activity after fingolimod cessation: Five\u2010year clinical outcomes"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2340-4409","authenticated-orcid":false,"given":"Bade","family":"Gulec","sequence":"first","affiliation":[{"name":"Department of Neurology Cerrahpasa School of Medicine, Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Everest","sequence":"additional","affiliation":[{"name":"Department of Neurology Cerrahpasa School of Medicine, Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ogeday Derin","family":"Gorkey","sequence":"additional","affiliation":[{"name":"Department of Neurology Cerrahpasa School of Medicine, Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metehan","family":"Koc","sequence":"additional","affiliation":[{"name":"Department of Neurology Cerrahpasa School of 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