Neurol. praxi. 2021;22(6):496-500 | DOI: 10.36290/neu.2021.096
Treatment of secondary progressive multiple sclerosis with siponimod and a case report
- Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze
Siponimod is a selective modulator of S1P1 and S1P5 subtypes of sphingosin-1 phosphate receptors with dual mechanism of action. It exerts the anti-inflammatory effect by blocking the egress of lymphocytes from the lymph nodes and the neuroprotective effect due to direct interaction with glial a neuronal brain cells. EXPAND clinical trial showed the positive effect of siponimod on the risk of disability progression, number of relapses, cognitive performance and activity and progression on MRI compared to placebo. Siponimod is indicated for the treatment of secondary progressive Multiple Sclerosis with disease progression and clinical or MRI activity, in adults. The dose of siponimod must be reduced in case of decreased CYP2C9 enzyme activity due to genetic polymorphism.
Keywords: multiple sclerosis, secondary progressive, siponimod, oral treatment, CYP2C9.
Received: December 1, 2021; Revised: December 1, 2021; Accepted: December 4, 2021; Prepublished online: December 4, 2021; Published: December 9, 2021 Show citation
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