SMC has recommended that Ponvory can be prescribed for people with relapsing remitting MS who are having relapses or have MRI evidence of MS activity and who prefer, or find it easier, to take medicine as a tablet.
This is very welcome news. The approval of Ponvory in Scotland increases the choices for people with relapsing 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
NICE is currently reviewing Ponvory for NHS use in England and Wales. Their preliminary decision did not recommend Ponvory as a treatment for relapsing remitting MS. NICE has asked the manufacturer for more detailed evidence and further analyses of the data. The MS Trust has also replied to NICE’s initial decision. NICE is reviewing the comments received and will publish its final decision later this year.
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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