Results from Expand, a phase III study, have revealed that treatment with siponimod (Mayzent) led to significant improvement in cognitive processing speed in patients with secondary progressive multiple sclerosis (SPMS).
This research was presented at the European Academy of Neurology in Oslo, titled “Siponimod Improves Cognitive Processing Speed in Patients with SPMS: Results from Phase 3 EXPAND Study”.
Of the 1,645 patients who took part in the study, 1,099 were treated with siponimod and 546 treated with a placebo. To assess cognitive processing speed they all underwent three assessments at six-monthly intervals. The tests were the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT), which are commonly used in clinical trials. In addition, the Brief Visuospatial Memory Test-Revised (BVMTR), which evaluates visual/spatial memory and is valid in MS patients was also used.
The results showed that siponimod reduced the risk of 3-point-confirmed cognitive worsening by 28.6% and 21.3% lower risk of a four-point confirmed worsening. It is worth noting that a four-point change in a SDMT score is considered clinically meaningful.
At 24 months, scores improved up to 40.6% in patients receiving siponimod, compared to up to 30.2% of those taking the placebo. It was also noted that changes from when the study first began also favoured siponimod.
The group scores for the PASAT and BVMTR tests were similar. Compared to when they first started the trial SDMT scores improved with siponimod in both relapsing secondary progressive MS and non-relapsing secondary progressive MS patients. A difference was only seen in PASAT testing in relapsing secondary progressive MS patients.
Researchers concluded that siponimod demonstrated a significant and clinically meaningful positive effect on cognitive processing speed as measured by SDMT in SPMS patients with or without relapses.