Key clinical point: Among patients with multiple sclerosis who initiate treatment with fingolimod, a low baseline heart rate may not increase the risk of first-dose cardiac events.

Major finding: Of 182 cardiac events during 20,001 first-dose observations, 87.4% occurred in patients with a normal baseline heart rate, 11.5% occurred in patients with mild bradycardia at baseline, and 1.1% occurred in patients with marked bradycardia at baseline.

Study details: An analysis of retrospective data from 5,572 in-home and 15,025 in-clinic first-dose observations.

Disclosures: Dr. Osborne reported receiving a consulting fee from Novartis, which markets Gilenya (fingolimod), and his coauthors are employees of Novartis.