Abstract
Multiple sclerosis is a chronic inflammatory disease of the central nervous system with autoimmune processes in pathogenesis, leading to substantial disability in young adults if untreated. Siponimod is a selective modulator of sfingosin-1-phosphate (S1P) receptors that was successfully investigated in both relapsing-remitting and secondary progressive multiple sclerosis.
It is the first approved oral medication in secondary progression, obviously for its ability not only to cross the blood-brain barrier but also to bind the S1P receptors in the brain, and for its ability to influence neurodegenerative processes which are responsible for disability progression in multiple sclerosis. Therefore, siponimod acts not only on inflammatory processes that are more connected with the onset of the disease.
Currently, the inflammation in relapsing-remitting multiple sclerosis can be treated with a number of approved drugs. The safety of the basic registered dose of siponimod of 2 mgs resembles the safety of other registered drugs in this class (S1P receptor modulators).
The advantage is the decrease of cardiac side effects and selectivity for S1P1 and S1P5 receptors. Titration of the dose is user friendly both for patients and physicians.
Monitoring the dose for possible bradycardia is not necessary anymore.