Siponimod for the treatment of secondary progressive multiple sclerosis

ABSTRACT

Introduction: Multiple sclerosis (MS) is a chronic central nervous system immune-mediated disease with an important inflammatory component associated with focal demyelination and widespread neurodegeneration. In most cases, the clinical presentation is relapsing-remitting, followed by a secondary progressive phase, characterized by disability accrual unrelated to relapses. In a minority, the phenotype is progressive from the beginning. Major therapeutic achievements have been made concerning the relapsing phase but modifying the evolution of progressive MS remains an unmet need.

Areas covered: This review covers siponimod (BAF312), a new sphingosine 1-phosphate receptor modulator, and its role in the treatment of secondary progressive MS. The authors reviewed PubMed English literature using the keywords ‘siponimod’ or ‘BAF312’ and ‘multiple sclerosis.’ They also present the pharmacological profile of siponimod, as well as clinical efficacy and safety, with emphasis on the recently published results of a Phase III trial. Phase II data in relapsing MS are also summarized.

Expert opinion: Siponimod may reduce the activity of the disease and has a modest effect on the gradual disability accrual. If approved, it may become one of the few available therapy options for secondary progressive MS.

KEYWORDS:

• BAF312
• disease-modifying therapies
• multiple sclerosis
• progressive multiple sclerosis
• siponimod
• sphingosine 1-phosphate

Declaration of interest

L Dumitrescu has received support for attending scientific meetings from AbbVie, Biogen Idec and Teva and consultancy fees from AbbVie. CS Constantinescu has received research grant support, support for attending scientific meetings, and consultancy fees from Biogen Idec, Bayer Schering, Genzyme, Merck Serono, Morphosys, Novartis, Roche, Sanofi Pasteur and Merck Sharp and Dohme. R Tanasescu has received support for attending scientific meetings from AbbVie, Biogen Idec, Teva and Genzyme. He was sub-investigator in several DMTs trials. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

One referee declares having received consulting fees from Novartis, the manufacturer of siponimod.

Additional information

Funding

No funding was received for this manuscript.