Effect of Siponimod on Cognition in MS Patients Explored

THURSDAY, Dec. 17, 2020 — Some cognitive tests but not others suggest siponimod may speed cognitive processing in patients with secondary progressive (SP) multiple sclerosis (MS), according to a study published online Dec. 16 in Neurology.

Ralph H.B. Benedict, Ph.D., from the University at Buffalo in New York, and colleagues conducted secondary analyses of data from a double-blind, phase 3 trial involving 1,651 SPMS patients randomly assigned to receive either siponimod or placebo in a 2:1 ratio. The Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and Brief Visuospatial Memory Test-Revised (BVMT-R) were used to assess cognitive function.

The researchers found that at months 12, 18, and 24, the between-group differences in mean change from baseline in SDMT scores were significantly better for siponimod-treated versus placebo-treated patients (difference, 1.08, 1.23, and 2.30, respectively). The risk for having a 4-point sustained decrease in SDMT score was significantly lower for siponimod-treated patients (hazard ratio, 0.79), while they had a higher chance of having a 4-point sustained increase in the SDMT score (hazard ratio, 1.28). There was no significant between-group difference observed in the PASAT or BVMT-R scores.

“We are impressed to see that siponimod may improve cognitive processing speed in people with MS; however, more research is needed to confirm our results,” Benedict said in a statement. “Because we did not see changes on two other cognitive tests, more research should further examine how siponimod affects scores on a broader array of thinking and memory tests.”

Several authors disclosed financial ties to biopharmaceutical companies, including Novartis, which manufactures siponimod and funded the study.

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