CMSC 2022 | S1P receptor modulators in the treatment of MS

Bruce Cree, MD, PhD, MAS, University of California San Francisco, San Francisco, CA, speaks about sphingosine-1-phosphate (S1P) receptor modulators for treating multiple sclerosis (MS). The first approved oral MS therapy of such form was fingolimod, which is less effective than newer therapies and remains restricted by a challenging adverse event profile. At present, three improved modulators are approved: ozanimod and siponimod, S1P1/5 selective agents, and ponesimod, being solely S1P1 selective. Data has shown more favorable adverse event profiles and improved half-lives of these drugs, allowing for self-administration by patients at home, instead of requiring first dose observations. The drugs have also demonstrated higher efficacy, measured by the reduction in relapse rates and new lesion formation. Given the strong efficacy demonstrated in trials, Dr Cree says that he would use S1P receptor modulators as frontline medications. More research is needed on the various agents as there is a rebound effect apparent with fingolimod, unexpectedly not observed for ozanimod. This interview took place at the Consortium of Multiple Sclerosis Centers (CMSC) congress 2022 in Maryland.