New possibility for SPMS treatment

[erash]

There are so many studies re. new meds but few target SPMS specifically. Perhaps??? this is promising?

SUMMARY AND COMMENT | NEUROLOGY

April 13, 2018

Siponimod for Secondary Progressive Multiple Sclerosis

Jaime Toro, MD reviewing Kappos L et al. Lancet 2018 Mar 31.

Is siponimod an effective and safe drug for the treatment of patients with secondary progressive multiple sclerosis?

Secondary progressive multiple sclerosis (SPMS) is an MS subtype characterized by worsening of disability that begins insidiously in patients with preceding relapsing-remitting (RR) course, which is the most common mode of onset. The risk for and timing of transition from RRMS to SPMS is unpredictable; however, up to 90% of RRMS may evolve to SPMS over a 25-year time interval. Several disease-modifying therapies have shown efficacy in reducing relapses and disease activity in RRMS, but most of these have failed to prevent disease worsening in progressive MS.

This multicenter, randomized, double-blind, placebo-controlled, manufacturer-funded phase 3 study was done at almost 300 hospital clinics and specialized MS centers in 31 countries. Researchers randomized 1651 patients with a diagnosis of SPMS to the investigational drug siponimod (1105 patients) or placebo (546 patients). Of these, 1327 (80%) completed the study (82% on siponimod vs. 78% on placebo). Median time on study was 21 months and median exposure to the drug was 18 months. Three-month confirmed disability progression, the primary outcome, occurred in 288 (26%) of 1096 patients receiving siponimod and 173 (32%) of 545 patients receiving placebo, a significant difference (hazard ratio, 0.79; relative risk reduction, 21%). Adverse events were reported in more siponimod than placebo recipients (89% of 1099 patients vs. 82% of 546 patients), including adverse events described previously with other sphingosine-1-phophate receptor modulators (e.g., bradycardia, hypertension, varicella zoster reactivation) and more serious adverse events (18% vs. 15%). Frequencies of infections, malignancies, and mortality were the same in both treatment groups.

Comment

In this study, siponimod reduced the risk for disability progression in a large population of patients, many of whom entered the study having already reached the nonrelapsing stage of SPMS with a high level of established disability. Although siponimod also had a good safety profile, other studies must be carried out to confirm that this drug could be an option in the treatment of SPMS.

[Jesmcd2 CommunityAmbassador]

I had read this @erash and I hope it works💕

[Kenu]

Thanks for the information and hopefully this works 👍 🙏🐾 Ken

[SueAB]

erash, Thanks for posting - seems like we are the stepchild for MS treatments!

[greaterexp]

I've been keeping an eye on that and am very hopeful that it will be effective and available. Thanks for posting and keeping us updated.