Abstract

Background: Siponimod-related lymphopenia in real-world clinical practice has implications for dose adjustment and infection risk. Objective: To characterise siponimod-related lymphopenia in people with secondary progressive multiple sclerosis (pwSPMS). Methods: This is a retrospective cohort of 188 pwSPMS. The development of grade 4 lymphopenia was interrogated with Kaplan–Meier survival analysis and binary logistic regression. Results: Lymphopenia develops soon after commencing siponimod. In total, 15 (8.5%) of 176 experienced grade 4 lymphopenia at 1 month after initiation. There were no clinically significant associations between patient characteristics and development of grade 4 lymphopenia. Conclusion: Grade 4 lymphopenia can occur soon after siponimod initiation and cannot be predicted.

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