The conversation is no longer about whether these treatments are effective
182-187 [online] Available at: Miranda, A.M., Steluti, J., Fisberg, R.M
Fingolimod has a pharmacologic half-life of 6-9 days and lymphocytes would be expected to normalize 2-4 weeks after discontinuation.Reference Johnson, Shames and Keezer 118 Therefore, it is recommended to stop fingolimod for 4 weeks, checking peripheral lymphocyte counts to ensure that they are returning towards normal before giving the first course of alemtuzumab, in order to maximize its effect on circulating lymphocytes.Reference Giovannoni, Marta and Davis 107 From a safety standpoint, moving from natalizumab or fingolimod (and probably DMF)agents that have proven in monotherapy to cause PMLto alemtuzumab requires additional consideration
Initially, it was approved for the treatment of type 2 diabetes, where it proved highly effective in improving blood sugar control