{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:16:23Z","timestamp":1783433783832,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delaying 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) \u2265\u20097.0 over the core part of the Phase 3 EXPAND study were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The time to sustained EDSS \u2265\u20097.0 (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\u2010label treatment. Subgroup analyses were conducted in participants with active versus non\u2010active SPMS (defined based on pre\u2010study\/baseline criteria), and in participants with baseline EDSS 6.5.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall EXPAND population, siponimod reduced the risk of reaching sustained EDSS \u2265\u20097.0 (requiring a wheelchair) by 40% (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.41\u20130.88;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) versus placebo; the reduction in risk was 51% (HR, 0.49; 95% CI, 0.29\u20130.81;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) versus placebo in participants with active SPMS and 22% (HR, 0.78; 95% CI, 0.42\u20131.45;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.437) in non\u2010active SPMS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Siponimod 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70659","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:55:11Z","timestamp":1780923311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Progression to Wheelchair in Secondary Progressive Multiple Sclerosis and Impact of Siponimod: Post Hoc Analyses From the\n                    <scp>EXPAND<\/scp>\n                    Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-8817","authenticated-orcid":false,"given":"Patrick","family":"Vermersch","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm U1172 LilNCog, FHU Precise  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Arnould","sequence":"additional","affiliation":[{"name":"Sanofi  Zwijnaarde (Gent) Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Neurology, St Josef's Hospital Ruhr University Bochum  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig","family":"Kappos","sequence":"additional","affiliation":[{"name":"Department 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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Fox","sequence":"additional","affiliation":[{"name":"Mellen Center for Treatment and Research in Multiple Sclerosis, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bar\u2010Or","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine, Center for Neuroinflammation and Experimental Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A. 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