Treatment Interruption and Cessation for Multiple Sclerosis
Stephen Krieger, MD; Daniel Bandari, MD, MS; Bruce Hughes, MD; Mitzi Williams, MD; and Heidi Crayton, MD, review data on short-term interruption of ponesimod vs teriflunomide when treating multiple sclerosis.
Stephen Krieger, MD: One of the points that many of you made is that when we stop, for instance, the newer generation of SP1 [sphingosine-1-phosphate receptor]modulators, they come out of the system pretty quickly. And so, one of the concerns I’ve had and that many folks have had in our field is with our cell trafficking blockers, like the S1Ps or even natalizumab, withdrawing those medicines has historically been associated with the risk of rebound MS [multiple sclerosis]. That we take away the cell trafficking inhibition, all of those cells are still in the system, and then they can get to where we don’t want them to go and cause new MS lesions. Rebound had been seen with natalizumab, with fingolimod. That concern has hung over the second generation of S1P modulators, the more selective ones. But now we’re finally starting to see some data that I find a bit reassuring in that respect. Dr Crayton, would you like to talk a bit about newer data on cessation or pausing treatment with either ozanimod or ponesimod and what those data look like?