Understanding MS progression

While everyone experiences relapsing forms
of multiple sclerosis (RMS) differently, it's not
unusual for your condition to change or
transition over time. If you're noticing new
symptoms, or if activities like walking are
becoming more challenging, it might mean
that your RMS is progressing.

Understanding MS progression

While everyone experiences relapsing forms of multiple sclerosis (RMS) differently, it's not unusual for your condition to change or transition over time. If you're noticing new symptoms, or if activities like walking are becoming more challenging, it might mean that your RMS is progressing.

The transition from RRMS to SPMS

Over 50% of people with RRMS transition to SPMS within 15 to 20 years

Relapsing-Remitting MS (RRMS)

The most common type of RMS, characterized by episodes of relapses (periods when symptoms get worse) and remissions (periods of partial or complete recovery).

Over 50% of people with RRMS transition to SPMS within 15 to 20 years.*

*Without treatment.

Active Secondary Progressive MS (SPMS)

The early stage of SPMS where:

You may have fewer relapses (at least 1 in the last 2 years) but your disability is still increasing

The number of active lesions appearing on your MRI may decrease

Your MS symptoms are getting worse, you're experiencing new ones, or they're lingering between relapses

Nonactive SPMS

If you no longer have relapses, you're considered to have nonactive SPMS.

How can I tell if I have active SPMS?

With active SPMS, you may have fewer relapses and may not be fully bouncing back or recovering in between. The number of active lesions appearing on your MRI may decrease as well. At the same time, you might notice your disability increasing. Trouble walking, relying more on a walking aid, and more difficulty doing daily activities on your own are common signs.

Since everyone experiences MS progression differently, only your doctor can determine if you have active SPMS. Talk to them right away if you're noticing any changes in your symptoms or day-to-day abilities.

How is disability progression measured?

The Expanded Disability Status Scale (EDSS) is commonly used in clinical trials to measure disability and track progression over time.

Your EDSS score is determined by how you function in 8 key areas, and can range from 0 to 10. The higher your EDSS score, the greater your level of disability.

KEY AREAS OF FOCUS FOR DETERMINING DISABILITY

Assistance
required to walk

Assistance required
to walk

Weakness or
problems moving
limbs

Weakness or problems moving limbs

Problems with coordination

Bowel and
bladder issues

Bowel and bladder issues

Trouble with
memory or
concentration

Vision problems

Difficulty with
speech or
swallowing

Difficulty with speech or swallowing

Numbness
or loss of
sensation

Numbness or loss
of sensation

Disability progression in active SPMS

Disability progression in active Secondary Progressive MS (SPMS)

To measure changes in disability during clinical trials, doctors commonly use confirmed disability progression (CDP). Any change in disability that remains consistent over a certain period of time, such as 3 months, is considered CDP.†

†CDP is not the only measure for disease progression.

What does all of this mean for me?

Even a small increase in your disability can impact day-to-day activities.
Answer a few questions about your MS, its daily impact, and how it might be changing
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INDICATION AND IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

Do not take MAYZENT if you:

have a CYP2C9*3/*3 genotype. Before starting treatment with MAYZENT, your CYP2C9 genotype should be determined by your health care provider. Ask your health care provider if you are not sure.
have had a heart attack, chest pain called unstable angina, stroke or mini-stroke (transient ischemic attack or TIA), or certain types of heart failure in the last 6 months

What is MAYZENT® (siponimod) tablets?

MAYZENT is a prescription medicine that is used to treat relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.

It is not known if MAYZENT is safe and effective in children.

have certain types of heart block or irregular or abnormal heartbeat (arrhythmia), unless you have a pacemaker

MAYZENT may cause serious side effects, including:

Slow heart rate (bradycardia or bradyarrhythmia) when you start taking MAYZENT. MAYZENT can cause your heart rate to slow down, especially after you take your first dose. You should have a test to check the electrical activity of your heart called an electrocardiogram (ECG) before you take your first dose of MAYZENT.

During the initial updosing period (4 days for the 1-mg daily dose or 5 days for the 2-mg daily dose), if you miss 1 or more doses of MAYZENT, you need to restart the updosing. Call your health care provider if you miss a dose of MAYZENT.
Infections. MAYZENT can increase your risk of serious infections that can be life-threatening and cause death. MAYZENT lowers the number of white blood cells (lymphocytes) in your blood. This will usually go back to normal within 3 to 4 weeks of stopping treatment. Your health care provider should review a recent blood test of your white blood cells before you start taking MAYZENT.

Call your health care provider right away if you have any of these symptoms of an infection during treatment with MAYZENT and for 3 to 4 weeks after your last dose of MAYZENT:
- fever
- tiredness
- body aches
- chills
- nausea
- vomiting
- headache with fever, neck stiffness, sensitivity to light, nausea, confusion (these may be symptoms of meningitis, an infection of the lining around your brain and spine)
A problem with your vision called macular edema. Macular edema can cause some of the same vision symptoms as a multiple sclerosis (MS) attack (optic neuritis). You may not notice any symptoms with macular edema. If macular edema happens, it usually starts in the first 1 to 4 months after you start taking MAYZENT. Your health care provider should test your vision before you start taking MAYZENT and any time you notice vision changes during treatment with MAYZENT. Your risk of macular edema is higher if you have diabetes or have had an inflammation of your eye called uveitis.

Call your health care provider right away if you have any of the following: blurriness or shadows in the center of your vision, a blind spot in the center of your vision, sensitivity to light, or unusually colored (tinted) vision.

Before taking MAYZENT, tell your health care provider about all of your medical conditions, including if you:

have an irregular or abnormal heartbeat
have a history of stroke or other diseases related to blood vessels in the brain
have breathing problems, including during your sleep
have a fever or infection, or you are unable to fight infections due to a disease or are taking medicines that lower your immune system. Tell your health care provider if you have had chickenpox or have received the vaccine for chickenpox. Your health care provider may do a blood test for chickenpox virus. You may need to get the full course of vaccine for chickenpox and then wait 1 month before you start taking MAYZENT.
have slow heart rate
have liver problems
have diabetes
have eye problems, especially an inflammation of the eye called uveitis
have high blood pressure
are pregnant or plan to become pregnant. MAYZENT may harm your unborn baby. Talk to your health care provider right away if you become pregnant while taking MAYZENT or if you become pregnant within 10 days after you stop taking MAYZENT.
- If you are a woman who can become pregnant, you should use effective birth control during your treatment with MAYZENT and for at least 10 days after you stop taking MAYZENT.
are breastfeeding or plan to breastfeed. It is not known if MAYZENT passes into your breast milk. Talk to your health care provider about the best way to feed your baby if you take MAYZENT.

Tell your health care provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements. Especially tell your health care provider if you take medicines to control your heart rhythm (anti-arrhythmics), or blood pressure (antihypertensives), or heart beat (such as calcium channel blockers or beta-blockers); take medicines that affect your immune system, such as beta-interferon or glatiramer acetate, or any of these medicines that you took in the past.

Tell your health care provider if you have recently received a live vaccine. You should avoid receiving live vaccines during treatment with MAYZENT. MAYZENT should be stopped 1 week before and for 4 weeks after receiving a live vaccine. If you receive a live vaccine, you may get the infection the vaccine was meant to prevent. Vaccines may not work as well when given during treatment with MAYZENT.

MAYZENT may cause possible side effects, including:

increased blood pressure. Your health care provider should check your blood pressure during treatment with MAYZENT.
liver problems. MAYZENT may cause liver problems. Your health care provider should do blood tests to check your liver before you start taking MAYZENT. Call your health care provider right away if you have any of the following symptoms of liver problems:
- nausea
- vomiting
- stomach pain
- tiredness
- loss of appetite
- your skin or the whites of your eyes turn yellow
- dark urine
breathing problems. Some people who take MAYZENT have shortness of breath. Call your health care provider right away if you have new or worsening breathing problems.
swelling and narrowing of the blood vessels in your brain. A condition called PRES (Posterior Reversible Encephalopathy Syndrome) has happened with drugs in the same class. Symptoms of PRES usually get better when you stop taking MAYZENT. However, if left untreated, it may lead to a stroke. Call your health care provider right away if you have any of the following symptoms: sudden severe headache, sudden confusion, sudden loss of vision or other changes in vision, or seizure.
severe worsening of multiple sclerosis after stopping MAYZENT. When MAYZENT is stopped, symptoms of MS may return and become worse compared to before or during treatment. Always talk to your doctor before you stop taking MAYZENT for any reason. Tell your health care provider if you have worsening symptoms of MS after stopping MAYZENT.

The most common side effects of MAYZENT include: headache, high blood pressure (hypertension), and abnormal liver tests.

These are not all of the possible side effects of MAYZENT. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

What is MAYZENT® (siponimod) tablets?

It is not known if MAYZENT is safe and effective in children.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see full Prescribing Information, including Medication Guide.

Understanding MS progression