ECTRIMS 2021: Ponesimod vs Teriflunomide for RRMS

A total of 10 Janssen-sponsored data abstracts on MS research will be presented at the 2021 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) virtual congress from October 13 to 15, in Vienna, Austria, including post-hoc analyses highlighting the benefit of ponesimod compared with teriflunomide and an analysis of increased clinical benefits in early patient use. Ponesimod, a once-daily oral selective sphingosine-1-phosphate receptor 1 (S1P1) modulator, was approved to treat adults with relapsing forms of MS in both the United States and European Union earlier this year.

Data Presentations Include:

Ponesimod demonstrated increased clinical benefit over teriflunomide in early disease subgroup compared with overall population
A subgroup analysis of the pivotal OPTIMUM trial, a Phase 3, randomized, double-blind study, demonstrated increased clinical benefits of ponesimod over teriflunomide by evaluating whether a patient population with early disease has a differential benefit with ponesimod compared to teriflunomide. The study demonstrated increased clinical benefits in terms of Confirmed Disability Accumulation (CDA) in early disease subgroups compared with the overall population and confirmed the advantage of using ponesimod as an early, high-efficacy treatment.

A short pause in ponesimod treatment completely restores the ability to mount post-vaccination antibody titers in mice
An open question is whether patients taking ponesimod can respond to a novel vaccine or would benefit from a drug holiday prior to vaccination. The antibody response after vaccination was blunted in mice that were maintained on ponesimod, but not when treatment is temporarily paused. These data suggest that briefly halting ponesimod treatment may help in achieving maximal vaccination effectiveness.

Effect of ponesimod compared to teriflunomide on concomitant corticosteroid treatment of relapse in patients with relapsing forms of multiple sclerosis
The objective of this analysis was to compare the use of corticosteroids for treatment of relapses between ponesimod and teriflunomide groups in OPTIMUM. In the OPTIMUM trial, patients with relapsing multiple sclerosis (RMS) treated with ponesimod achieved a lower rate of concomitant Systemic Corticosteroids (SCS) usage for the management of relapses compared with patients treated with teriflunomide.

Ponesimod shows improved effect on Brain Volume Loss (BVL) over other MS Disease Modifying Treatments, based on Model-Based Meta-Analysis (MBMA)
The MBMA included longitudinal BVL data from 21 eligible Randomized Clinical Trials (RCTs) that investigated 11 unique drugs and placebo. Ponesimod appears to lead to less BVL at 2 years than placebo and all 10 other comparators in the network, including other S1P receptor modulators, orals and anti-CD20 B cell depleting monoclonals.

Empowerment of multiple sclerosis patients in treatment decision-making
This study evaluated the degree to which MS patients are empowered in treatment decisions and attitudes regarding their role in MS treatment choice. The study was conducted using data from the Adelphi MS Disease Specific Programme, a cross-sectional survey of neurologists and their MS patients in the US and several European countries between December 2020 and May 2021. It was found in this study that many MS patients play an active role in treatment decision-making, and patients in the US reported a higher engagement and greater likelihood to receive medication they request.

Understanding symptoms and their impact on patients with multiple sclerosis: what we can learn from social media
This study evaluated real-world evidence from social media, including patient forums, to understand the prevalence and impact of symptoms among patients with MS by collecting data-set keywords and overall sentiment toward fatigue burden. The data collected show that fatigue was reported as the most prevalent symptom. The consistency of these findings, with previous research using other methods of analysis, suggests that social media data can be a valuable source of insight into patients’ experience of MS symptoms.

A complete listing of Janssen-sponsored abstracts is provided below. Abstracts can also be viewed on the ECTRIMS virtual congress 2021 website.