NICE has recommended that Ponvory can prescribed for people with relapsing remitting MS (RRMS) who are having relapses or have MRI evidence of MS activity. This reverses an earlier decision by NICE to reject Ponvory for relapsing RRMS.
This is very welcome news. The approval of Ponvory by NICE increases the choices for people with relapsing remitting MS, particularly for those who prefer taking a tablet. A wider range of treatments that work in different ways and have different benefits and risks means that people can work with their consultant to find the treatment that is best for them.
- David Martin, Chief Executive Officer, MS Trust
NHS England is required to support prescribing of Ponvory within three months of this approval, and NHS Wales must support prescriptions within two months.
In Scotland, Ponvory was approved in November as a treatment for people with active relapsing remitting MS who prefer, or find it easier, to take medicine as a tablet.
In Northern Ireland, the Department of Health reviews and endorses appropriate NICE appraisals.
Ponvory is taken as a tablet, once daily. A low dose is taken initially which is gradually increased over the first week. This reduces the risk of slowing the heart rate.
In a two year clinical trial, Ponvory reduced the risk of relapses by 30% compared to Aubagio (teriflunomide) and reduced the number of new active lesions seen on MRI. Those on Ponvory also had a statistically significant improvement in fatigue symptoms compared to Aubagio. There was a trend toward less disability progression on Ponvory, but this was not statistically different to Aubagio.
The most common side effects reported in clinical trials were nasopharyngitis (common cold), headache, chest infections and an increase in liver enzymes measured in the blood. Seizures and macular oedema (swelling at the back of the eye) occurred more frequently in those taking Ponvory.
Ponvory belongs to the same class of drugs as Gilenya (fingolimod). It works by retaining lymphocytes (immune cells) in lymph nodes. The number of lymphocytes reaching the brain is decreased, which reduces the immune attack on nerve cells in the brain and spinal cord.
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