Cladribine to treat disease exacerbation after fingolimod discontinuation in progressive multiple sclerosis

Rebound disease following cessation of disease modifying treatment (DMT) has been reported in people with both relapsing and progressive multiple sclerosis (pwRMS, pwPMS) questioning strict separation between these two phenotypes. While licensedDMTis available for pwRMSto counter rebound disease, no such option exists for pwPMS. We report on a pwPMSwho developed rebound disease, with 45 Gadolinium‐enhancing lesions on T1weightedMRIbrain, within 6 months after fingolimod 0.5 mg/day was stopped. Treatment with a short course of subcutaneous cladribine 60 mg led to effective suppression of inflammatory activity and partial recovery with no short‐term safety issues or adverse events.