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Annals of clinical and translational neurology
Apr, 2024;11 (4): 842-855.

Sphingosine 1-phosphate receptor modulators in multiple sclerosis treatment: A practical review.

Patricia K Coyle, Mark S Freedman, Bruce A Cohen, Bruce A C Cree, Clyde E Markowitz
Author Information
  1. Patricia K Coyle: Department of Neurology, Stony Brook Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
  2. Mark S Freedman: University of Ottawa, Department of Medicine and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  3. Bruce A Cohen: Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
  4. Bruce A C Cree: Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA. ORCID
  5. Clyde E Markowitz: Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
PMID: 38366285 DOI: 10.1002/acn3.52017

Abstract

Four sphingosine 1-phosphate (S1P) receptor modulators (fingolimod, ozanimod, ponesimod, and siponimod) are approved by the US Food and Drug Administration for the treatment of multiple sclerosis. This review summarizes efficacy and safety data on these S1P receptor modulators, with an emphasis on similarities and differences. Efficacy data from the pivotal clinical trials are generally similar for the four agents. However, because no head-to-head clinical studies were conducted, direct efficacy comparisons cannot be made. Based on the adverse event profile of S1P receptor modulators, continued and regular monitoring of patients during treatment will be instructive. Notably, the authors recommend paying attention to the cardiac monitoring guidelines for these drugs, and when indicated screening for macular edema and cutaneous malignancies before starting treatment. To obtain the best outcome, clinicians should choose the drug based on disease type, history, and concomitant medications for each patient. Real-world data should help to determine whether there are meaningful differences in efficacy or side effects between these agents.

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Grants

  1. /Bristol Myers Squibb

MeSH Term

United States
Humans
Multiple Sclerosis
Sphingosine 1 Phosphate Receptor Modulators
Sphingosine-1-Phosphate Receptors
Fingolimod Hydrochloride
Administration, Oral

Chemicals

Sphingosine 1 Phosphate Receptor Modulators
Sphingosine-1-Phosphate Receptors
Fingolimod Hydrochloride
Journal Article Review

Word Cloud

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