Do I need to Stop Taking Gilenya before my surgery?

Here is My Question:
I am currently taking Gilenya. I've been on it since before it got approved. I was in a clinical trial. I'm facing hip replacement surgery in the next couple of months. I'm getting mixed information about the necessity to stop Gilenya a month before the surgery. I don't want to stop it as I don't want the risk of the relapse. What is the latest recommendation?

This question was posed see you in May of 2017 and I want to know if there's any new or different information and/or recommendation.

Answer:
I can think of no reasons to discontinue Gilenya before or after a hip replacement. Stopping Gilenya a month prior to surgery would require you to undergo another first dose observation period when you restart it post operatively and would put you at risk for a rebound relapse. There is a black box warning in the package insert about stopping Gilenya without an alternative treatment to prevent rebound relapses.

You've been on Gilenya for over a decade without complications. It makes no medical sense to stop it except for the day of surgery when you are NPO.

Gilenya will not affect healing or your ability to form clots. There is no evidence it increases the risk of post-operative infections.
Hope this information helps

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego