Current dia­gnostics of secondary progressive form of multiple sclerosis and its treatment with siponimod

Authors: P. Štourač
Authors‘ workplace: Neurologická klinika LF MU a FN Brno
Published in: Cesk Slov Neurol N 2020; 83/116(4): 364-367
Category: Review Article
doi: 10.14735/amcsnn2020364


Multiple sclerosis is a chronic inflammatory disease of the CNS. Secondary progressive MS is the second most common form of MS worldwide and symptomatic treatment is currently the only available option in the Czech Republic. Neurodegeneration and less inflammatory processes are the main pathophysiological processes underlying the transition to the secondary progressive phase of MS. Because of clinical dia­gnostic obstacles, the dia­gnosis of secondary progressive MS is often postponed by 3 years. Dia­gnostic criteria based on the data from MSBase registry enable the elimination of this dia­gnostic gap. Siponimod is the first oral drug for the treatment of secondary progressive MS with clinical or MRI activity reducing the disability progression or selected MRI parameters. The efficacy and safety of siponimod were tested in the phase III clinical trial EXPAND. The most suitable criteria for treatment with siponimod and its safety profile including possibilities in the case of treatment failure are under scrutiny of the scientific neurological society in the Czech Republic.


diagnosis – treatment – secondary progressive multiple sclerosis – siponimod


1. Multiple Sclerosis International Federation (MSIF)  Atlas of MS 2013. [online]. Available from URL: https: // MS.pdf.

2. Khurana V, Sharma H, Medin J et al. Estimated prevalence of dia­gnosed secondary progressive multiple sclerosis in the Americas and Europe: results from a systematic literature search. Neurology 2018; 90 (15 Suppl): P2.380.

3. Scalfari A, Neuhaus A, Daumner M et al. Onset of secondary progressive phase and long-term evolution of multiple sclerosis. J Neurol Neurosurg Psychiatry 2014; 85 (1): 67–75. doi: 10.1136/jnnp-2012-304333.

4. Cree BA, Gourraud PA, Oksenberg JR et al. Long- -term evolution of multiple sclerosis disability in the treatment era. Ann Neurol 2016; 80 (4): 499–510. doi: 10.1002/ana.24747.

5. Coret F, Perez-Miralles FC, Gascon F et al. Onset of secondary progressive multiple sclerosis is not influenced by current relapsing multiple sclerosis therapies. Mult Scler J Exp Transl Clin 2018; 4 (2): 2055217318783347. doi: 10.1177/2055217318783347.

6. Lorscheider J, Buzzard K, Jokubaitis et al. Defining secondary progressive multiple sclerosis. Brain J Neurol 2016; 139 (9): 2395–2405. doi: 10.1093/brain/aww173.

7. Katz Sand I, Krieger S, Faqrrell C et al. Dia­gnostic uncertainity during the transition to secondary progressive multiple sclerosis. Mult Scler 2014; 20 (12): 1654–1657. doi: 10.1177/1352458514521517.

8. Inojosa H, Proschmann U, Akgun K et al. A focus on secondary progressive multiple sclerosis (SPMS): challenges in dia­gnosis and definition. J Neurol 2019; [ahead of print]. doi: 10.1007/s00415-019-09489-5.

9. Goodman D, Anadani N, Gerwitz L. Siponimod in the treatment of multiple sclerosis. Expert Opin Investig  Drugs 2019; 28 (15): 1051–1057. doi: 10.1080/13543784. 2019.1676725.

10. Brinkman V. FTY 20 (fingolimod) in multiple sclerosis: therapeutic effect in the immune and the central nervous system. Br J Pharmacol 2009; 158 (5): 1173–1182. doi: 10.1111/j.1476-5381.2009.00451.x.

11. Gentile A, Musella A, Bullita S et al. Siponimod (BAF 312) prevents synaptic neurodegeneration in experimetal multiple sclerosis. J Neuroinflammation 2016; 13 (1): 207. doi: 10.1186/s12974-016-0686-4.

12. Kappos L, Bar-Or A, Cree B, et al. Siponimod versus placebo in secondary progressive multiple sclerosis (EXPAND): a double-blind, randomised, phase 3 study. Lancet 2018; 391 (10127): 1263–1273. doi: 10.1016/S0140-6736 (18) 30475-6.

13. Mayzent. Souhrn údajů o přípravku. [online]. Dostupné z URL: https: //

14. SÚKL. Státní ústav pro kontrolu léčiv. Gilenya – Souhrn údajů o přípravku. [online]. Dostupné z URL: http: //

Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 4

2020 Issue 4

Most read in this issue
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account