a Department of Neurosciences, University of Medicine and Pharmacy Carol Davila, Department of Neurology , Colentina Hospital , Bucharest , Romania.
b Academic Clinical Neurology, Division of Clinical Neuroscience , University of Nottingham , Nottingham , UK.
Expert Opin Pharmacother. 2019 Feb;20(2):143-150. doi: 10.1080/14656566.2018.1551363. Epub 2018 Dec 5.
Multiple sclerosis (MS) is a chronic central nervous system immune-mediated disease with an important inflammatory component associated with focal demyelination and widespread neurodegeneration. In most cases, the clinical presentation is relapsing-remitting, followed by a secondary progressive phase, characterized by disability accrual unrelated to relapses. In a minority, the phenotype is progressive from the beginning. Major therapeutic achievements have been made concerning the relapsing phase but modifying the evolution of progressive MS remains an unmet need. Areas covered: This review covers siponimod (BAF312), a new sphingosine 1-phosphate receptor modulator, and its role in the treatment of secondary progressive MS. The authors reviewed PubMed English literature using the keywords 'siponimod' or 'BAF312' and 'multiple sclerosis.' They also present the pharmacological profile of siponimod, as well as clinical efficacy and safety, with emphasis on the recently published results of a Phase III trial. Phase II data in relapsing MS are also summarized. Expert opinion: Siponimod may reduce the activity of the disease and has a modest effect on the gradual disability accrual. If approved, it may become one of the few available therapy options for secondary progressive MS.
多发性硬化症（MS）是一种慢性中枢神经系统免疫介导疾病，具有重要的炎症成分，与局灶性脱髓鞘和广泛的神经退行性变有关。在大多数情况下，临床表现为复发缓解型，随后是继发性进行性阶段，其特点是与复发无关的残疾进展。在少数情况下，从一开始就表现为进行性。在缓解期已经取得了重大的治疗成就，但改变进行性 MS 的进展仍然是一个未满足的需求。涵盖领域：本文综述了新型鞘氨醇 1-磷酸受体调节剂西尼莫德（BAF312）及其在治疗继发进展性多发性硬化症中的作用。作者使用关键词“西尼莫德”或“BAF312”和“多发性硬化症”在 PubMed 英文文献中进行了检索。他们还介绍了西尼莫德的药理学特征，以及临床疗效和安全性，重点介绍了最近发表的 III 期试验结果。复发型 MS 的 II 期数据也进行了总结。专家意见：西尼莫德可能会降低疾病的活动度，并对逐渐发生的残疾进展产生适度的影响。如果获得批准，它可能成为治疗继发进展性 MS 的少数几种可用治疗选择之一。
