Rebound exacerbation multiple sclerosis following cessation of oral treatment.
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Background Multiple sclerosis (MS) management is changing, revolutionized by oral agents. Immune Reconstitution Inflammatory Syndrome (IRIS) describes exaggerated response to both exogenous (infective) and endogenous (non-infective) antigens. Methods This paper reports two cases of MS “rebound” following withdrawal of oral treatments. Results Two patients, with suboptimal response to interferons, trialled oral MS treatment (fingolimod and BG12) with excellent response. Upon cessation both experienced MS “rebound” which responded to steroids. Conclusions “Rebound” may occur following withdrawal of oral MS therapies. Patients should be advised accordingly and possibly started on alternative treatment before the immunomodulating effect of therapy has subsided.
Multiple Sclerosis and Related Disorders
Medical and Health Sciences