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Master Thesis

Élévation de la gamma glutamyl-transferase chez les patients sous fingolimod en traitement de fond d'une sclérose en plaques rémittente-récurrente

Abstract : Like all treatments for multiple sclerosis, fingolimod can cause drug-induced liver damage. The guidelines for transaminases monitoring were updated in 2020, but no specific monitoring exists for isolated elevation of gamma-GT. Our study aimed to describe the prevalence of elevation of GGT under fingolimod in patients followed at the Caen University Hospital for relapsing-remitting MS and to identify possible risk factors for elevation. The secondary objectives were to identify the repercussions on the management of the patients and to determine if this increase could constitute a predictive factor of impaired hepatic function. 64% of patients on fingolimod had an elevation in GGT and 18% of patients on fingolimod had a severe elevation (> 5N). Risk factors for elevation of GGT were length of treatment, male gender, and overweight / obesity. The presence of a disturbed initial liver function test was a risk factor for increased gamma-GT> 5N. Half-dose reduction of fingolimod when GGTs were < 5N normalized liver function tests in 50% of patients, it did not allow normalization of values once gamma-GT> 5N. Liver tests were reassuring as to the question of definitive liver damage, but the increase in GGT seems to predict the subsequent elevation of transaminases. These results raise questions about the primary and secondary prevention of GGT elevation on fingolimod.
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https://dumas.ccsd.cnrs.fr/dumas-03596686
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Submitted on : Thursday, March 3, 2022 - 6:30:13 PM
Last modification on : Wednesday, April 13, 2022 - 3:44:52 AM

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  • HAL Id : dumas-03596686, version 1

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Anne-Laure Lajoye. Élévation de la gamma glutamyl-transferase chez les patients sous fingolimod en traitement de fond d'une sclérose en plaques rémittente-récurrente. Médecine humaine et pathologie. 2021. ⟨dumas-03596686⟩

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