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Gilenya (Fingolimod hydrochloride) & Cardiac Congenital Malformations, Urinary Congenital Malformations, Other Non-Cardiac and Non-Urinary Congenital Malformations, and All Congenital Malformations

    Basic Details
    Status
    Complete
    Last Updated
    Thursday, July 17, 2025
    Original Posting Date
    Health Outcome(s)
    all congenital malformations
    cardiac congenital malformations (primary)
    urinary congenital malformations (primary)
    Purpose
    Drug and Outcome Analysis
    Meets requirements of FD&C Act Sec 505(o) prior to requiring a PMR
    No
    Study Summary

    The FDA initiated this study in the Sentinel System to investigate whether in utero exposure to fingolimod, indicated for the treatment of relapsing forms of multiple sclerosis (MS), is associated with an increased risk of cardiac and urinary malformations. This study was prompted by interim reports from the Gilenya Pregnancy Registry, conducted as a postmarketing requirement, which indicated a higher prevalence of congenital malformations, specifically cardiac and urinary, among infants exposed to fingolimod in utero compared to the general U.S. population and infants born to mothers with untreated MS.

    The primary objective of this study was to assess the risk of cardiac and urinary congenital malformations in live births from pregnant women exposed to fingolimod during the first trimester of pregnancy. Results indicated an insufficient number of pregnant women exposed to fingolimod during the first trimester or during the 45-day pre-pregnancy period to reach any informative conclusions regarding the risk of congenital malformations.

    The results supported FDA’s evaluation of the pregnancy safety signal pertaining to in utero fingolimod exposure.