b'Medicine & Researchtypically help as much with spasms or pain ve varieties and depending upon their type,in MS. play dierent roles in the human body. OneMarijuana-basedproductswillcontain class of S1P receptor affects the ability ofhigher amounts of THC and may be eective lymphocytes to leave lymph nodes and is thein managing spasticity, central neuropathic desired target in MS. Other S1P receptorspain, and urinary frequency and urgency. aect blood pressure through vasodilation.Studies on an FDA-approved 1:1 CBD/THC Yet another class may aect heart rate becausesublingual spray for MS spasticity should be oftheirpresenceonthecardiacelectricalstarting by years end. Until then, people with conduction system. Fingolimod aects multipleMS will need to look at their state laws to see S1P receptor classes and can be associatedwhat is allowed and available. with a lowered heart rate, especially within therst six hours of the rst oral dose. OzanimodResearchers compare ozanimod is a more selective S1P receptor modulator.and ngolimod for safety, ecacy There have been no studies comparingThis is an industry led study by Analysis the safety and eectiveness of ozanimod toGroup, Inc. and US HEOR, Bristol-Myers Squibb fingolimod in a head-to-head trial. In thisto compare two sphingosine 1-phosphate article, the authors compared the two drugsreceptor-modulating therapies for relapsing across their respective studies to get a sense ofMS, ozanimod and fingolimod. The study comparative safety and eectiveness. Within theindirectly compares clinical trials conducted limitations of that type of indirect comparison,on these two drugs by using a matching- it does appear that ozanimod was linked toadjusted indirect comparison to adjust for better safety and equal effectiveness asdifferences in the trials. There were two measured by relapse rate reduction andozanimod clinical trials with 2,659 patients slowing of disability progression. Ozanimodand three ngolimod clinical trials with 3,667 is FDA-approved and scheduled for releasepatients. The inclusion criteria for all the on June 1.trials was similar with only a few exceptionsregardingmeasurements.Afterreviewingthe adverse events, cardiac monitoring, andone-yearoutcomesozanimodshowedsignificantly lower risks in all areas. Theauthors note this MAIC showed ozanimodasafavorabletreatmentcomparedtofingolimod, but a longer-term comparisonand a true randomized control trial is stillneeded.Dr. Thrower:Gilenya(ngolimod)wastherst FDA-approved oral disease-modifyingtherapy for MS. Gilenya, Mayzent (siponimod),and the recently approved Zeposia (ozanimod)are all in a class of drugs called S1P orsphingosine phosphate receptor modulators.Sphingosine phosphate receptors come inmsfocusmagazine.org 54'