Advances in oral immunomodulating therapies in relapsing multiple sclerosis

Publication date: Available online 11 February 2020Source: The Lancet NeurologyAuthor(s): Tobias Derfuss, Matthias Mehling, Athina Papadopoulou, Amit Bar-Or, Jeffrey A Cohen, Ludwig KapposSummaryBackgroundOral treatment options for disease-modifying therapy in relapsing multiple sclerosis have substantially increased over the past decade with four approved oral compounds now available: fingolimod, dimethyl fumarate, teriflunomide, and cladribine. Although these immunomodulating therapies are all orally administered, and thus convenient for patients, they have different modes of action. These distinct mechanisms of action allow better adaption of treatments according to individual comorbidities and offer different mechanisms of treatment such as inhibition of immune cell trafficking versus immune cell depletion, thereby substantially expanding the available treatment options.Recent developmentsNew sphingosine-1-phosphate receptor (S1PR) modulators with more specific S1PR target profiles and potentially better safety profiles compared with fingolimod were tested in patients with relapsing multiple sclerosis. For example, siponimod, which targets S1PR1 and S1PR5, was approved in March, 2019, by the US Food and Drug Administration for the treatment of relapsing multiple sclerosis including active secondary progressive multiple sclerosis. Ozanimod, another S1P receptor modulator in the approval stage that also targets S1PR1 and S1PR5, reduced relapse rates and MRI activity in two ...

Source: The Lancet Neurology - February 12, 2020 Category: Neurology Source Type: research