An expert provided context on a subanalysis of the EXPAND study that evaluated the effect of baseline age on the efficacy and safety of siponimod (Mayzent; Novartis) in secondary progressive multiple sclerosis.
Le Hua, MD: The original EXPAND study had been presented, so we wanted to look at a subgroup analysis of those who were younger than 50 [years] and older than 50 [years]. This is a follow-up study. We’ve looked at young age differences before, using 45 [years] as the cutoff point. The reason we focused on 50 [years] is because we’re learning more about progressive disease.
As you can see from CMSC and ECTRIMS, there’s a lot of focus on older patients. We wanted to see if there’s a difference when we separate those patients out into younger and older. Thankfully, in our study, we were able to see that confirmed disability progression was also reduced in both the under 50 and over 50 age groups. In those less than 50 [years], 3-month confirmed disability progression was reduced by 31%. In those over 50, the 3-month confirmed disability progression was reduced by 38%.
Again, what’s nice about this data is that EXPAND really focused on the secondary progressive patients. Even when we separate out the older patients versus the younger patients, we still see an effect in the older age group. Of course, the caution is that when we separate out and do the subgroup analysis, the numbers become smaller. Any post-hoc analysis always has the standard limitations we’re aware of; however, those results are still instructive and give us an idea of what to expect.