Evidence map›Paper›PMID 42257510›Full record

Trial reportEuropean journal of neurology2026

Progression to Wheelchair in Secondary Progressive Multiple Sclerosis and Impact of Siponimod: Post Hoc Analyses From the EXPAND Study.

Patrick Vermersch, Sophie Arnould, Ralf Gold, Ludwig Kappos, Robert Fox, Amit Bar-Or, Bruce A C Cree, Soudeh Ansari, Daniela Piani Meier, Goeril Karlsson and 2 more

Abstract readRandomized Controlled TrialClinical Trial, Phase III
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Patrick VermerschUniversité de Lille, Inserm U1172 LilNCog, FHU Precise, Lille, France.ORCID https://orcid.org/0000-0003-0997-8817
Sophie ArnouldSanofi, Zwijnaarde (Gent), Belgium.
Ralf GoldDepartment of Neurology, St Josef's Hospital, Ruhr University Bochum, Bochum, Germany.
Ludwig KapposDepartment of Head, Organs, Movement and Neuromedicine, Clinical Research, Biomedicine and Biomedical Engineering, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital and University of Basel, Basel, Switzerland.
Robert FoxMellen Center for Treatment and Research in Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Amit Bar-OrDepartment of Neurology, Perelman School of Medicine, Center for Neuroinflammation and Experimental Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Bruce A C CreeDepartment of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.
Soudeh AnsariNovartis Pharma AG, Basel, Switzerland.
Daniela Piani MeierAres Trading SA, Eysins, Switzerland, an Affiliate of Merck KGaA, Darmstadt, Germany.
Goeril KarlssonNovartis Pharma AG, Basel, Switzerland.
Nicolas RouyrreNovartis Pharma AG, Basel, Switzerland.ORCID https://orcid.org/0000-0002-7847-0235
Gavin GiovannoniFaculty of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0001-9995-1700

Funding

Novartis pharma AG basel switzerland
6 · The paper itself

Abstract

backgroundDelaying time to requiring a wheelchair in people living with MS is an important treatment goal to maintain quality of life and guard against increased healthcare costs. In this post hoc analysis, the effects of siponimod versus placebo on time to sustained Expanded Disability Status Scale (EDSS) ≥ 7.0 over the core part of the Phase 3 EXPAND study were assessed.

methodsThe time to sustained EDSS ≥ 7.0 (time to requiring a wheelchair) was analysed for participants with secondary progressive multiple sclerosis (SPMS). Analyses were based on a While on Treatment (WOT) set that censored participants if entering open-label treatment. Subgroup analyses were conducted in participants with active versus non-active SPMS (defined based on pre-study/baseline criteria), and in participants with baseline EDSS 6.5.

resultsIn the overall EXPAND population, siponimod reduced the risk of reaching sustained EDSS ≥ 7.0 (requiring a wheelchair) by 40% (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.41-0.88; p = 0.009) versus placebo; the reduction in risk was 51% (HR, 0.49; 95% CI, 0.29-0.81; p = 0.005) versus placebo in participants with active SPMS and 22% (HR, 0.78; 95% CI, 0.42-1.45; p = 0.437) in non-active SPMS.

conclusionSiponimod reduced the risk of requiring a wheelchair in participants with SPMS versus participants receiving placebo, with a greater effect in those with active disease. Time to requiring a wheelchair is a highly relevant treatment goal and an important indicator of treatment effect in patients with SPMS.

Indexed as

AzetidinesBenzyl CompoundsMultiple Sclerosis, Chronic ProgressiveSphingosine 1 Phosphate Receptor ModulatorsWheelchairsAdultDisease ProgressionDouble-Blind MethodFemaleHumansMaleMiddle AgedAzetidinesBenzyl CompoundssiponimodSphingosine 1 Phosphate Receptor ModulatorsMarkov modelmulti‐state modelsecondary progressive multiple sclerosissiponimodsustained EDSS ≥ 7.0wheelchair

Identifiers

PMID42257510
PMCPMC13244661

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.