Historical note and nomenclature
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By K K Jain MD

Fingolimod, first synthesized in 1992, is derived from myriocin, a metabolite of the fungus Isaria sinclairii, found to have immunosuppressive properties. Fingolimod belongs to a class of disease-modifying agents called sphingosine 1 phosphate (S1P) receptor modulators. It was originally tested in clinical trials on renal transplant patients but not found to be superior to the conventional immunosuppressant agents and, hence, not developed further for this indication. On June 16, 2010, the FDA's Peripheral and Central Nervous System Drugs Advisory Committee recommended approval of fingolimod as an oral therapy for the treatment of patients with relapsing-remitting multiple sclerosis. It is undergoing FDA review for final approval. It will be one of the first orally active drug therapies to be made available for the treatment of relapsing-remitting multiple sclerosis.