The Benefits and Risks of Switching from Fingolimod to Siponimod for the Treatment of Relapsing-Remitting and Secondary Progressive Multiple Sclerosis

Drugs R D. 2023 Dec;23(4):331-338. doi: 10.1007/s40268-023-00434-6. Epub 2023 Aug 28.

Abstract

Multiple sclerosis (MS) is a chronic neurodegenerative disease that affects the central nervous system (CNS). Currently, MS treatment is limited to several Food and Drug Administration (FDA)- and European Medicines Agency (EMA)-approved medications that slow disease progression by immunomodulatory action. Fingolimod and siponimod have similar mechanisms of action, and consequently, their therapeutic effects may be comparable. However, while fingolimod is mainly used for relapsing-remitting MS (RRMS), siponimod, according to EMA label, is recommended for active secondary progressive MS (SPMS). Clinicians and scientists are analysing whether patients can switch from fingolimod to siponimod and identifying the advantages or disadvantages of such a switch from a therapeutic point of view. In this review, we aim to discuss the therapeutic effects of these two drugs and the advantages/disadvantages of switching treatment from fingolimod to siponimod in patients with the most common forms of MS, RRMS and SPMS.

Publication types

  • Review

MeSH terms

  • Fingolimod Hydrochloride / adverse effects
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis, Chronic Progressive* / chemically induced
  • Multiple Sclerosis, Chronic Progressive* / drug therapy
  • Neurodegenerative Diseases* / chemically induced
  • Neurodegenerative Diseases* / drug therapy
  • Recurrence
  • Risk Assessment

Substances

  • Fingolimod Hydrochloride
  • siponimod
  • Immunosuppressive Agents