Bruce Cree, MD, PhD, MAS, University of California San Francisco, San Francisco, CA, gives an update on the 7-year results of the ongoing EXPAND-extension study investigating the long-term efficacy of siponimod versus placebo in preventing disability worsening in patients with secondary progressive multiple sclerosis (SPMS). During the randomized controlled study period (NCT01665144), patients who experienced confirmed disability worsening over a period of six months were switched to the extension study where they received active treatment instead of placebo. When the randomized period ended, all patients moved to the extension study. To compare the long-term efficacy of continuous siponimod with placebo, Rank Preserving Structural Failure Time (RPSFT) was used to model the performance of patients if they had continued with placebo treatment. Overall, the analysis suggested that early use of siponomod in SPMS could be associated with long-term beneficial outcomes. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) congress 2021.