Siponimod Shows EDSS Subscale Benefits in Secondary Progressive MS

Novartis’s S1P receptor modulator siponimod (Mayzent) showed benefits in a number of patients with SPMS on the Motor Integration and Collateral subscales of the Expanded Disability Status Scale.By: Matt Hoffman

By: Matt Hoffman

Published: April 29, 2020

Bruce Cree, MD, PhD, MAS

Findings from a new analysis of EXPAND clinical trial (NCT01665144) data suggest that patients with secondary progressive multiple sclerosis (MS) who are treated with siponimod (Mayzent; Novartis) experience a sustained benefit, with a slowing of physical disability progression and addition of cognitive protection.^1,2

Using a pair of new subscales of the Expanded Disability Status Scale (EDSS)—Motor Integration (MI), which measures ambulation and cerebellar/pyramidal functions, and Collateral (C), which measures bowel and bladder, brainstem, cerebral, sensory, and visual functions—the findings were consistent with the earlier analyses of fingolimod (Gilenya; Novartis), thus confirming siponimod’s benefits.

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These data were originally accepted for presentation at the canceled American Academy of Neurology (AAN) 2020 Annual Meeting.

“These data highlight the critical importance of early treatment intervention with a disease-modifying treatment, such as Mayzent, to ensure the best possible long-term outcomes for patients with MS who are experiencing progression,” Bruce Cree, MD, PhD, MAS, clinical research director, and George A. Zimmermann Endowed Professor in Multiple Sclerosis, UCSF School of Medicine, said in a statement. “It’s never too early to stay ahead of progression in multiple sclerosis, since the early identification of physical and cognitive changes—even subtle ones—can indicate MS disease progression and therefore allow for timely intervention.”

In total, the analysis included 1645 patients, of which 1099 were administered the sphingosine 1-phosphate (S1P) receptor modulator and 546 given placebo, and showed that significant treatment effects were detected over the 36-month study period for EDSS scores (P = .020), as well as both the MI (P = .014) and C (P = .021) subscales. The effect size favored siponimod from the 6-month mark and onward.

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