The sustained effectiveness and consistent long-term safety profile of 2 mg/day siponimod (a selective sphingosine-1-phosphate receptor modulator) up to > five years supported its clinical utility for long-term management of secondary progressive multiple sclerosis, according to the findings of a study published in The Multiple Sclerosis Journal.

Siponimod considerably decreased the risk of confirmed disability progression, deterioration in cognitive processing speed, relapses, and magnetic resonance imaging measures of brain atrophy and inflammation vs placebo in multiple sclerosis people in the Phase III EXPAND study. Investigators undertook this study to determine siponimod's long-term effectiveness and safety from the EXPAND study including the extension part, up to > five years.

In the open-label extension part, the volunteers treated with placebo during the core part were switched to siponimod (placebo-siponimod arm) and those on siponimod continued the same therapy (continuous siponimod arm). When compared to placebo-siponimod group, the continuous siponimod minimized the risk of six-month confirmed disability advancement by 22% and 6-month confirmed worsening in cognitive processing speed by 23%.

Sustained effectiveness on annualized relapse rate, total and regional brain atrophy, and inflammatory disease activity was also witnessed. Over the long term, no novel, unexpected safety signals for siponimod were detected. The benefits in the continuous siponimod vs placebo-siponimod group highlighted the significance of earlier commencement of therapy.