Switching Patients With Multiple Sclerosis to S1P Receptor Modulator


Krzysztof Selmaj, MD, PhD, provides key clinical considerations when switching patients with multiple sclerosis (MS) to sphinogine-1-phospate (S1P) receptor modulator treatment.


Krzysztof Selmaj, MD, PhD: Obviously now, assessment of efficacy is important. As with other drugs for MS [multiple sclerosis] that are in the market now, the primary efficacy is measured by [whether the drugs] stop MS development or slow disease development, and this is assessed by clinical measures. We need to evaluate the patients clinically and conduct a regular neurologic exam. Of course, in addition, we should take MRIs, I mentioned that a monitoring MRI should be taken once every year. But if there’s some risk for PML [progressive multifocal leukoencephalopathy], it should be taken immediately. This is from the perspective of effectiveness. From the perspective of safety, as I said, the first adverse effects may occur after 3 to 6 months of treatment. At that time, you also should pay attention to monitoring measures, liver enzymes, OCT [optical coherence tomography], also blood pressure measurements. It’s not very demanding, but this is necessary to monitor for safety.

On the whole, I can say that the tolerance of these drugs is very good. There are long observational studies with the selective S1P [sphingosine-1-phosphate] receptor modulators, in particular with ozanimod, that show a mild safety pattern. And we can follow these monitoring measures to potentially pick up some adverse events. Treatment with these drugs is not particularly difficult, and it’s one of the advantages in relation to some other drugs we are using for multiple sclerosis today.

Transcript edited for clarity.

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