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The following is a summary of “Effect of siponimod on retinal thickness, a marker of neurodegeneration, in participants with SPMS: Findings from the EXPAND OCT substudy,” published in the January 2025 issue of Neurology by Vermersch et al.
Retinal layer thinning in Multiple Sclerosis (MS) associates with clinical disability, brain atrophy, and neurodegeneration, functioning as a potential biomarker for disease progression and treatment response.
Researchers conducted a retrospective study to examine the utility of retinal thickness as a surrogate marker of neurodegeneration and treatment effect in participants with secondary progressive MS (SPMS) from the optical coherence tomography (OCT) substudy of the EXPAND Phase 3 clinical trial (siponimod vs placebo).
They analyzed treatment effects on the change in an average retinal layer thickness, peripapillary retinal nerve fiber layer (pRNFL), and combined macular ganglion cell and inner plexiform layers (GCIPL) using high-definition spectral domain OCT at 3, 12, and 24 months in a population of 159 participants.
The results showed that thinning from baseline occurred across all retinal layers and time points in the placebo group. Siponimod significantly reduced macular GCIPL thinning at month 24 (adjusted mean [SE] [µm]: −0.47 [0.81] vs −4.29 [1.23]; P =0.01), as well as overall retinal thinning at months 12 (+0.66 [0.54] vs −1.86 [0.75]; P =0.006) and 24 (−0.05 [0.59] vs −2.30 [0.88]; P =0.033) while, the results for the pRNFL followed similar trends.
Investigators concluded that this exploratory substudy supports further investigation of OCT measurement of retinal atrophy as a non-invasive potential biomarker of treatment effects on neurodegeneration in SPMS.
Source: msard-journal.com/article/S2211-0348(25)00003-3/abstract
