…MS onset) and most did not have inflammatory disease activity (64% relapse-free in the previous two years; 75% with no Gd+ lesions). The relative reduction in 6-month confirmed disability progression was 26% with siponimod after a median time on treatment of 21 months. The FDA rejected the SPMS indication, stating that there was insufficient evidence of a treatment benefit for patients with non-active SPMS. Instead, it opted to approve siponimod…

…(Swallow et al. J Comp Eff Res 2020;9:275-285). Both drugs are sphingosine-1-phosphate (S1P) receptor agonists that act as functional antagonists, sequestering T cells in secondary lymphoid organs. Fingolimod acts on S1PR-1,3,4,5, whereas ozanimod (like siponimod) is selective to S1PR1,5. Ozanimod was approved in Canada for the treatment of relapsing MS in October 2020. There are no head-to-head studies of the two S1P agents, so a matching-adjust…