{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:29:38Z","timestamp":1787563778011,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T00:00:00Z","timestamp":1767398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T00:00:00Z","timestamp":1767398400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Background:<\/jats:title>\n \n Gilenya\n \u00ae<\/jats:sup>\n (fingolimod), a sphingosine-1-receptor agonist, is an effective treatment for multiple sclerosis (MS). However, increased relapse activity has been observed after transitioning to generic fingolimod despite prior prolonged disease stability.\n <\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n \n To quantify the clinical and radiological impact of transitioning from Gilenya\n \u00ae<\/jats:sup>\n to generic fingolimod in people with MS (PwMS).\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Retrospective data were evaluated from a single tertiary MS care center. Time to magnetic resonance imaging (MRI) activity and clinical relapse was assessed during Gilenya\n \u00ae<\/jats:sup>\n and generic fingolimod treatment. Differences in absolute lymphocyte count (ALC) and side effects were also measured by treatment group.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The cohort included 88 PwMS (71 female; 76 White, mean age when starting Gilenya\n \u00ae<\/jats:sup>\n was 39.6\u2009years (standard deviation (SD)\u2009=\u200910.6\u2009years), and mean age when starting generic fingolimod was 46.9 years (SD\u2009=\u200911.2 years)). A shorter time to MRI activity (\n p<\/jats:italic>\n \u2009=\u20090.0026) and time to relapse (\n p<\/jats:italic>\n \u2009=\u20090.0027) was observed during generic fingolimod treatment. The ALC increased by 8.81% after generic fingolimod treatment, relative to Gilenya\n \u00ae<\/jats:sup>\n (95% CI\u2009=\u2009(2.00%, 16.08%),\n p<\/jats:italic>\n \u2009=\u20090.01), with an intersubject variability of 1.97%. A 2.45-fold increase in side effects was observed with generic fingolimod relative to Gilenya\n \u00ae<\/jats:sup>\n (95% CI\u2009=\u2009(1.38, 4.36),\n p<\/jats:italic>\n \u2009=\u20090.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Measures of disease stability appear less optimal with generic fingolimod based on serological, clinical, and radiological measures.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/13524585251401404","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T11:15:29Z","timestamp":1767438929000},"page":"192-201","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and radiological outcomes of directed treatment transitions from Gilenya\n \u00ae<\/sup>\n to generic fingolimod"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8245-2336","authenticated-orcid":false,"given":"Mahi A","family":"Patel","sequence":"first","affiliation":[{"name":"College of Osteopathic Medicine, Kansas City University, Kansas City, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2969-2360","authenticated-orcid":false,"given":"Tom G","family":"Punnen","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S","family":"Shan","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8378-460X","authenticated-orcid":false,"given":"Morgan C","family":"McCreary","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal M","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4747-9610","authenticated-orcid":false,"given":"Shanan B","family":"Munoz","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Hardeman","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy W","family":"Burgess","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2091-8201","authenticated-orcid":false,"given":"Benjamin M","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6040-1947","authenticated-orcid":false,"given":"Lindsay A","family":"Horton","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1825-575X","authenticated-orcid":false,"given":"Peter V","family":"Sguigna","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0214-633X","authenticated-orcid":false,"given":"Lauren M","family":"Tardo","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O\u2019Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0469-6872","authenticated-orcid":false,"given":"Olaf","family":"St\u00fcve","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; 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