Ponesimod Bests Aubagio in Head-to-Head MS Trial

STOCKHOLM — Ponesimod, an investigational selective sphingosine-1-phosphate receptor 1 (S1P1) modulator, bested teriflunomide (Aubagio) in a head-to-head trial of adult relapsing multiple sclerosis (MS) patients, researchers for the OPTIMUM phase III trial reported here.

Compared with teriflunomide — an approved first-line oral MS drug — oral ponesimod reduced annual relapse rate (ARR) by 30.5% over about 2 years, according to Ludwig Kappos, MD, of University Hospital of Basel in Switzerland, and co-authors, in a presentation at the 2019 ECTRIMS Congress. At 108 weeks, ponesimod 20 mg had an ARR of 0.202, compared with an ARR for teriflunomide 14 mg of 0.290 (P=0.0003).

“This is the first head-to-head study comparing a new compound with one of the oral drugs,” Kappos said in an interview with MedPage Today. Comparative studies had been conducted in the past with injectable MS drugs, he noted, but this trial aims to place ponesimod within the spectrum of the oral drugs, “which are getting to be, more and more, the standard treatment.”

Ponesimod is a selective modulator of the sphingosine-1 phosphate receptor, like fingolimod (Gilenya) and siponimod (Mayzent). Binding of the drug to the receptor lowers the number of circulating lymphocytes by trapping them in the lymph nodes, reducing the number of lymphocytes that could enter the central nervous system and damage myelin.

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