Fingolimod

Introduction
Fingolimod is an immunomodulator used for treating multiple sclerosis. Specifically, it is a sphingosine-1-phosphate receptor modulator, which causes lymphocytes to sequester in lymph nodes, preventing them from contributing to autoimmunity.

PML
Although rare, there is an estimated risk of 0.083 cases per 1,000 people worldwide.

IRIS can develop several weeks after fingolimod discontinuation and is usually mild.

Patients over age 45 may be higher risk.