S1P Receptor Modulators and the Treatment Landscape of Relapsing-Remitting Multiple Sclerosis


Krzysztof Selmaj, MD, PhD, discusses the treatment landscape for relapsing-remitting multiple sclerosis (RRMS) and where sphinogine-1-phospate (S1P) receptor modulators fit in.


Krzysztof Selmaj, MD, PhD: Sphingosine-1 phosphate receptors modulators represent a new category of drugs. They’re the first drug from the of S1P receptor category on the market in the last 10 years. We’ve entered a new period of development with these drugs. There are a number of free selective S1P receptor modulators. It all depends how many types of receptors these drugs target.

Fingolimod targets 4 of 5 types of receptors present in our body. Selective modulators target receptor only types 1 and 5, or just receptor type 1.

These are highly effective oral drugs. This group of drugs is known as HETAs, or highly effective treatment agents. They fit our strategy for treating multiple sclerosis [MS]. They can be used orally for the naïve patients. We’re switching from the escalation strategy, which is when we wait for the patient to worsen before treating with higher-efficacy drugs. We now treat with highly efficacious drugs orally from the beginning.

S1P receptor modulators can be given to patients who have more aggressive multiple sclerosis with more active lesions. They also play a role in S1P receptor modulators for drugs for switching of treatment, when we treat patients with other MS drugs, mostly the platform drugs like glatiramer acetate and dimethyl fumarate. Patients who don’t respond well to these therapies can be switched to S1P receptor modulators. Patients who don’t respond well to high-efficacy drugs can be switched as well. That strategy can meet expectation in many aspects of treatment of our patients.

Transcript edited for clarity.

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