Much research continues to pour into sphingosine receptor modulators, not least because of their somewhat novel mechanism of action. Currently, there is only one active drug in this class – fingolimod – that is used in the treatment of multiple sclerosis. It’s worth noting that the drug does not cure multiple sclerosis but, instead, helps patients tolerate the condition while reducing relapses. Specifically, this medication is a sphingosine-1-receptor modulator, serving to sequester immune cells and prevent these cells from entering the central nervous system. Given that multiple sclerosis is an inflammatory condition, fingolimod acts to modulate the body’s immune response to this condition. Given the novelty of this class of drugs, the side-effect profile is incomplete. In other words, more data needs to be accrued to establish whether or not certain side-effects are due to fingolimod itself or due to the combination of fingolimod with other drugs used in the treatment of multiple sclerosis. In addition, there are numerous clinically significant interactions that the prescriber will need to take into consideration. Though this drug is a relatively recent addition to MS treatment, fingolimod has demonstrated sufficient efficacy to be considered a worthwhile addition to treatment regimens.
Sphingosine Receptor Modulators Drugs
Sphingosine Receptor Modulator drugs include:
Sphingosine Receptor Modulators Uses
Sphingosine receptor modulators are currently only used in the treatment of multiple sclerosis. Research is currently underway to determine whether the anti-inflammatory properties of this class of drugs can be extended to other conditions – specifically those conditions that require immunomodulating effects. In addition, this class of drugs is currently being investigated in other areas, such as for specific kinds of cancer. Given the latent potential for sphingosine receptor modulators, time will tell whether they prove to have other used beyond that of multiple sclerosis.
Sphingosine Receptor Modulators Side Effects
A complete side-effect profile has not yet been completely established, but certain patterns have begun to emerge. A small minority of patients also experience bradycardia, a symptom where the heart beats too slow and may result in more serious cardiac problems depending on the patient. Some of the side effects that have been reported include:
Sphingosine Receptor Modulators Interactions
Patients taking drugs that prolong the QT interval in the heart are at risk of torsade de pointes if taken with fingolimod. In addition, the patient may find their ECG is taken on first administration of the drug, due to a small minority of patients experiencing marked bradycardia. Furthermore, drugs that reduce the heart rate, such as beta-blockers, should be avoided if possible in patients taking fingolimod. Care should be taken if the patient is taking drugs that reduce the immune response or have an immunomodulating effect. This is liable to increase the risk of contracting an infection, as well as reducing the ability with which patients can fight the infection itself.
Fingolimod should also be avoided in azole drugs such as ketoconazole. It has been established that levels of fingolimod rise substantially when taken with the azole drug class. It has also been revealed that even after patients stop taking fingolimod, the effects of vaccines is markedly reduced for up to 2-3 months. Therefore, if possible, vaccines should be given after this latency period to ensure maximum benefit from the vaccine in question.