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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">nnp</journal-id><journal-title-group><journal-title xml:lang="en">Neurology, Neuropsychiatry, Psychosomatics</journal-title><trans-title-group xml:lang="ru"><trans-title>Неврология, нейропсихиатрия, психосоматика</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2074-2711</issn><issn pub-type="epub">2310-1342</issn><publisher><publisher-name>"IMA-Press", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/2074-2711-2025-6-69-74</article-id><article-id custom-type="elpub" pub-id-type="custom">nnp-2740</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL INVESTIGATIONS</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ И МЕТОДИКИ</subject></subj-group></article-categories><title-group><article-title>Experience with siponimod for treating patients with secondary progressive multiple sclerosis in the Moscow Region</article-title><trans-title-group xml:lang="ru"><trans-title>Опыт использования сипонимода для лечения пациентов со вторично-прогрессирующим рассеянным склерозом в Московской области</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1509-9608</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белова</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Belova</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129110, Москва, ул. Щепкина, 61/2</p></bio><bio xml:lang="en"><p>61/2, Shchepkina St., Moscow 129110</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-9726-7679</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пешкин</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Peshkin</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Александр Николаевич Пешкин</p><p>129110, Москва, ул. Щепкина, 61/2</p></bio><bio xml:lang="en"><p>Alexander Nikolaevich Peshkin</p><p>61/2, Shchepkina St., Moscow 129110</p></bio><email xlink:type="simple">kornef_alex@icloud.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2245-309X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Якушина</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakushina</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129110, Москва, ул. Щепкина, 61/2</p></bio><bio xml:lang="en"><p>61/2, Shchepkina St., Moscow 129110</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0367-8282</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лиждвой</surname><given-names>В. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Lizhdvoy</surname><given-names>V. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129110, Москва, ул. Щепкина, 61/2</p></bio><bio xml:lang="en"><p>61/2, Shchepkina St., Moscow 129110</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ МО «Московский областной научно-клинический институт им. М.Ф. Владимирского»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>M.F. Vladimirsky Moscow Regional Research Clinical Institute</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>20</day><month>12</month><year>2025</year></pub-date><volume>17</volume><issue>6</issue><fpage>69</fpage><lpage>74</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Belova Y.A., Peshkin A.N., Yakushina T.I., Lizhdvoy V.Y., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Белова Ю.А., Пешкин А.Н., Якушина Т.И., Лиждвой В.Ю.</copyright-holder><copyright-holder xml:lang="en">Belova Y.A., Peshkin A.N., Yakushina T.I., Lizhdvoy V.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://nnp.ima-press.net/nnp/article/view/2740">https://nnp.ima-press.net/nnp/article/view/2740</self-uri><abstract><p>Siponimod is a sphingosine-1-phosphate receptor modulator approved in most countries for the treatment of secondary progressive multiple sclerosis (SPMS) with activity. The EXPAND study showed that the drug effectively reduces disease activity at the peripheral level by preventing autoreactive immune cells from leaving the lymph nodes, as well as reducing neurodegeneration by limiting the development of central inflammation and promoting oligodendrocyte survival. To more fully assess the therapeutic effect of siponimod, it is necessary to analyse the efficacy and safety of the drug in real-world clinical practice.</p><sec><title>Objective</title><p>Objective. To evaluate the effect of siponimod on disease activity and progression in patients with SPMS in real-world clinical practice.</p></sec><sec><title>Material and methods</title><p>Material and methods. A retrospective-prospective observational cohort study was conducted in real-world clinical practice, involving 162 patients receiving siponimod and monitored at the Centre for Multiple Sclerosis and Other Neuroimmunological Diseases (CMS), organised on the basis of the M.F. Vladimirsky Moscow Regional Scientific and Clinical Institute.</p></sec><sec><title>Results</title><p>Results. In patients with active MS, stabilisation of the condition was observed in 76.7% of cases after 24 months. The number of exacerbations in SPMS decreased threefold with siponimod therapy. 86.7% of patients remained compliant with therapy in the second year. No adverse events requiring discontinuation of siponimod therapy for medical reasons were reported in the study group.</p></sec><sec><title>Conclusion</title><p>Conclusion. The results obtained demonstrate the high efficacy and favourable safety profile of siponimod and are consistent with data from clinical trials. Stabilisation of the condition, minimal side effects, oral administration and a convenient dosing regimen increase patient compliance when using this drug.</p></sec></abstract><trans-abstract xml:lang="ru"><p>Сипонимод является модулятором рецептора сфингозин-1-фосфата, одобренным в большинстве стран для терапии вторично-прогрессирующего рассеянного склероза (ВПРС) с активностью. В исследовании EXPAND было показано, что препарат эффективно воздействует как на снижение активности заболевания на периферическом уровне, препятствуя выходу аутореактивных иммунных клеток из лимфатических узлов, так и на процессы нейродегенерации, ограничивая развитие центрального воспаления и способствуя выживаемости олигодендроцитов. Для более полной оценки терапевтического влияния сипонимода необходимо проведение анализа эффективности и безопасности применения препарата в реальной клинической практике.</p><p>Цель исследования – оценить влияние сипонимода на активность и прогрессирование заболевания у пациентов с ВПРС в условиях реальной клинической практики.</p><sec><title>Материал и методы</title><p>Материал и методы. Проведено ретроспективно-проспективное наблюдательное когортное исследование в условиях реальной клинической практики, включавшее 162 пациентов, получающих сипонимод и наблюдающихся в Центре рассеянного склероза и других нейроиммунологических заболеваний (ЦРС), организованном на базе Московского областного научно-клинического института им. М.Ф. Владимирского.</p></sec><sec><title>Результаты</title><p>Результаты. У пациентов с активным течением РС стабилизация состояния через 24 мес отмечена в 76,7% случаев. Число обострений при ВПРС снизилось в 3 раза на фоне терапии сипонимодом. Комплаентными ко второму году терапии оставались 86,7% пациентов. Нежелательных явлений, потребовавших отмены терапии препаратом сипонимод по медицинским показаниям, в обследованной группе пациентов не было зарегистрировано.</p></sec><sec><title>Заключение</title><p>Заключение. Полученные результаты свидетельствуют о высокой эффективности и благоприятном профиле безопасности сипонимода и соответствуют данным клинических исследований. Стабилизация состояния, минимум побочных эффектов, пероральный прием и удобный режим дозирования повышают комплаентность пациентов при использовании данного препарата.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>сипонимод</kwd><kwd>вторично-прогрессирующий рассеянный склероз</kwd><kwd>препараты</kwd><kwd>изменяющие течение рассеянного склероза</kwd></kwd-group><kwd-group xml:lang="en"><kwd>siponimod</kwd><kwd>secondary progressive multiple sclerosis</kwd><kwd>disease-modifying treatments</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование не имело спонсорской поддержки</funding-statement><funding-statement xml:lang="en">The investigation has not been sponsored</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Goldenberg MM. Multiple sclerosis review. P T. 2012;37:175-84.</mixed-citation><mixed-citation xml:lang="en">Goldenberg MM. Multiple sclerosis review. P T. 2012;37:175-84.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Rovaris M, Confavreux C, Furlan R, et al. Secondary progressive multiple sclerosis: current knowledge and future challenges. Lancet Neurol. 2006;5(4):343-54.</mixed-citation><mixed-citation xml:lang="en">Rovaris M, Confavreux C, Furlan R, et al. Secondary progressive multiple sclerosis: current knowledge and future challenges. Lancet Neurol. 2006;5(4):343-54.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Клинические рекомендации «Рассеянный склероз». Доступно по ссылке: https://cr.minzdrav.gov.ru/view-cr/739_2</mixed-citation><mixed-citation xml:lang="en">Clinical practice guidelines for multiple sclerosis. Available at: https://cr.minzdrav.gov.ru/view-cr/739_2</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Bierhansl L, Hartung HP, Aktas O, et al. Thinking outside the box: non-canonical targets in multiple sclerosis. Nat Rev Drug Discov. 2022;21(8):578-600.</mixed-citation><mixed-citation xml:lang="en">Bierhansl L, Hartung HP, Aktas O, et al. Thinking outside the box: non-canonical targets in multiple sclerosis. Nat Rev Drug Discov. 2022;21(8):578-600.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Baker D, Marta M, Pryce G, et al. Memory B Cells are Major Targets for Effective Immunotherapy in Relapsing Multiple Sclerosis. EBioMedicine. 2017;16:41-50.</mixed-citation><mixed-citation xml:lang="en">Baker D, Marta M, Pryce G, et al. Memory B Cells are Major Targets for Effective Immunotherapy in Relapsing Multiple Sclerosis. EBioMedicine. 2017;16:41-50.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Zuo M, Wang AA, Gommerman JL. Follicle on the Roof: Tertiary Lymphoid Structures in Central Nervous System Autoimmunity. Immunol Rev. 2025;332(1):e70045.</mixed-citation><mixed-citation xml:lang="en">Zuo M, Wang AA, Gommerman JL. Follicle on the Roof: Tertiary Lymphoid Structures in Central Nervous System Autoimmunity. Immunol Rev. 2025;332(1):e70045.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Serafini B, Rosicarelli B, Magliozzi R, et al. Detection of ectopic B-cell follicles with germinal centers in the meninges of patients with secondary progressive multiple sclerosis. Brain Pathol. 2004;14(2):164-74.</mixed-citation><mixed-citation xml:lang="en">Serafini B, Rosicarelli B, Magliozzi R, et al. Detection of ectopic B-cell follicles with germinal centers in the meninges of patients with secondary progressive multiple sclerosis. Brain Pathol. 2004;14(2):164-74.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Preziosa P, Pagani E, Meani A, et al. Slowly Expanding Lesions Predict 9-Year Multiple Sclerosis Disease Progression. Neurol Neuroimmunol Neuroinflamm. 2022;9(2):e1139.</mixed-citation><mixed-citation xml:lang="en">Preziosa P, Pagani E, Meani A, et al. Slowly Expanding Lesions Predict 9-Year Multiple Sclerosis Disease Progression. Neurol Neuroimmunol Neuroinflamm. 2022;9(2):e1139.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Hauser SL, Cree BAC. Treatment of Multiple Sclerosis: A Review. Am J Med. 2020;133(12):1380-90.e2.</mixed-citation><mixed-citation xml:lang="en">Hauser SL, Cree BAC. Treatment of Multiple Sclerosis: A Review. Am J Med. 2020;133(12):1380-90.e2.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Yong HYF, Yong VW. Mechanism-based criteria to improve therapeutic outcomes in progressive multiple sclerosis. Nat Rev Neurol. 2022;18(1):40-55.</mixed-citation><mixed-citation xml:lang="en">Yong HYF, Yong VW. Mechanism-based criteria to improve therapeutic outcomes in progressive multiple sclerosis. Nat Rev Neurol. 2022;18(1):40-55.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Matloubian M, Lo CG, Cinamon G, et al. Lymphocyte egress from thymus and peripheral lymphoid organs is dependent on S1P receptor 1. Nature. 2004;427:355-60.</mixed-citation><mixed-citation xml:lang="en">Matloubian M, Lo CG, Cinamon G, et al. Lymphocyte egress from thymus and peripheral lymphoid organs is dependent on S1P receptor 1. Nature. 2004;427:355-60.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Gergely P, Nuesslein-Hildesheim B, Guerini D, et al. The selective sphingosine 1-phosphate receptor modulator BAF312 redirects lymphocyte distribution and has species-specific effects on heart rate. Br J Pharmacol. 2012;167:1035-47.</mixed-citation><mixed-citation xml:lang="en">Gergely P, Nuesslein-Hildesheim B, Guerini D, et al. The selective sphingosine 1-phosphate receptor modulator BAF312 redirects lymphocyte distribution and has species-specific effects on heart rate. Br J Pharmacol. 2012;167:1035-47.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">O’Sullivan C, Schubart A, Mir AK, et al. The dual S1PR1/S1PR5 drug BAF312 (siponimod) attenuates demyelination in organotypic slice cultures. J Neuroinflammation. 2016;13:31.</mixed-citation><mixed-citation xml:lang="en">O’Sullivan C, Schubart A, Mir AK, et al. The dual S1PR1/S1PR5 drug BAF312 (siponimod) attenuates demyelination in organotypic slice cultures. J Neuroinflammation. 2016;13:31.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Gentile A, Musella A, Bullitta S, et al. Siponimod (BAF312) prevents synaptic neurodegeneration in experimental multiple sclerosis. J Neuroinflammation. 2016;13:207.</mixed-citation><mixed-citation xml:lang="en">Gentile A, Musella A, Bullitta S, et al. Siponimod (BAF312) prevents synaptic neurodegeneration in experimental multiple sclerosis. J Neuroinflammation. 2016;13:207.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Ward LA, Lee DS, Sharma A, et al. Siponimod therapy implicates Th17 cells in a preclinical model of subpial cortical injury. JCI Insight. 2020;5(1):e132522. doi: 10.1172/jci.insight.132522</mixed-citation><mixed-citation xml:lang="en">Ward LA, Lee DS, Sharma A, et al. Siponimod therapy implicates Th17 cells in a preclinical model of subpial cortical injury. JCI Insight. 2020;5(1):e132522. doi: 10.1172/jci.insight.132522</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Benedict RHB, Tomic D, Cree BA, et al. Siponimod and cognition in secondary progressive multiple sclerosis: EXPAND secondary analyses. Neurology. 2020;96:e376-e386.</mixed-citation><mixed-citation xml:lang="en">Benedict RHB, Tomic D, Cree BA, et al. Siponimod and cognition in secondary progressive multiple sclerosis: EXPAND secondary analyses. Neurology. 2020;96:e376-e386.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Arnold DL, Fox R, Bar-Or A, et al. Effect of siponimod on cortical grey matter and thalamic volume in patients with secondary progressive multiple sclerosis – results of the EXPAND study. In: 35th ECTRIMS Congress; 11–13 September 2019; Stockholm, Sweden; 2019. P382.</mixed-citation><mixed-citation xml:lang="en">Arnold DL, Fox R, Bar-Or A, et al. Effect of siponimod on cortical grey matter and thalamic volume in patients with secondary progressive multiple sclerosis – results of the EXPAND study. In: 35th ECTRIMS Congress; 11–13 September 2019; Stockholm, Sweden; 2019. P382.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Инструкция по медицинскому применению препарата Кайендра®. Доступно по ссылке: https://grls.minzdrav.gov.ru/Grls_View_v2.aspx?routingGuid=24823e95-0c35-4f8e-8b10ed32c3947292</mixed-citation><mixed-citation xml:lang="en">Instructions for the medical use of Kiendra® (In Russ.). Available at: https://grls.minzdrav.gov.ru/Grls_View_v2.aspx?routingGuid=24823e95-0c35-4f8e-8b10ed32c3947292</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Selmaj K, Li DK, Hartung HP, et al. Siponimod for patients with relapsing-remitting multiple sclerosis (BOLD): an adaptive, dose-ranging, randomised, phase 2 study. Lancet Neurol. 2013;12:756-67.</mixed-citation><mixed-citation xml:lang="en">Selmaj K, Li DK, Hartung HP, et al. Siponimod for patients with relapsing-remitting multiple sclerosis (BOLD): an adaptive, dose-ranging, randomised, phase 2 study. Lancet Neurol. 2013;12:756-67.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Ksiazek-Winiarek DJ, Szpakowski P, Glabinski A. Neural plasticity in multiple sclerosis: the functional and molecular background. Neural Plast. 2015;2015:307175.</mixed-citation><mixed-citation xml:lang="en">Ksiazek-Winiarek DJ, Szpakowski P, Glabinski A. Neural plasticity in multiple sclerosis: the functional and molecular background. Neural Plast. 2015;2015:307175.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Dahlke F, Arnold DL, Aarden P, et al. Characterisation of MS phenotypes across the age span using a novel data set integrating 34 clinical trials (NO.MS cohort): age is a key contributor to presentation. Mult Scler. 2021;27:2062-76.</mixed-citation><mixed-citation xml:lang="en">Dahlke F, Arnold DL, Aarden P, et al. Characterisation of MS phenotypes across the age span using a novel data set integrating 34 clinical trials (NO.MS cohort): age is a key contributor to presentation. Mult Scler. 2021;27:2062-76.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
