“We can extract from animal models that, yes, it might have this effect, it might have neuroprotective effects, but we never really know 100%. But, it’s reassuring because the whole story is that we probably need to treat both the peripheral immune components as well as the CNS component.”

At the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) forum, February 27-29, 2020, in West Palm Beach, Florida, Le Hua, MD, director, Multiple Sclerosis Program, Cleveland Clinic Lou Ruvo Center for Brain Health, and colleagues presented data from a subanalysis of the EXPAND study of siponimod in patients with secondary progressive multiple sclerosis (SPMS).

The analysis stratified patients by their ages, under and over the age of 45 years, at baseline. In total, the cohort consisted of 779 patients, of which 473 were ≥45 years old (siponimod, n = 213; placebo, n = 93) and 306 were <45 years old (siponimod, n = 303; placebo, n = 170). Those younger than 45 years experienced a reduced risk of 3-month confirmed disease progression (CDP) by 31.9% compared with placebo (hazard ratio [HR], 0.68; 95% CI, 0.45–1.04; P = .0734), and 6 month CDP risk by 39.5% (HR, 0.61; 95% CI, 0.38–0.96; P = .0339). Those 45 years and older reduced the risk of 3-month and 6-month CDP by 31.5% (HR, 0.69; 95% CI, 0.48–0.97; P = .0340) and 33.1% (HR, 0.67; 95% CI, 0.45–1.0; P = .0471), respectively, versus placebo.1

The aim of the assessment was to further explore some of the complexities which surface when treating patients with MS as they age, particularly when their chronological and immunological ages can be so different. To find out more about what these data mean and what still needs to be elucidated, NeurologyLive spoke with Hua on the floor at ACTRIMS.

For more coverage of ACTRIMS 2020, click here.
REFERENCES
1. Hua L, Bar-Or A, Lublin FD, Meng X, Su W, Cree BA, Fox R. Analyses Of The Effect Of Baseline Age On The Efficacy And Safety Of Siponimod In Patients With Active SPMS From The Expand Study. Presented at 2020 ACTRIMS Forum. February 27-29, 2020; West Palm Beach, FL. Abstract P029.