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One-to-two months after once-daily drug intake, steady-state blood accumulation will be nearly 10-fold higher than the concentrations achieved following the initial dose (David et al., 2012)

Although not studied, an interaction of topiramate and valproate may exacerbate existing defects or unmask deficiencies in susceptible persons

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In the phase 3 EXPAND study, siponimod reduced the risk of 3-month confirmed disability progression by 21% compared with placebo and slowed the rate of brain volume loss over 12 and 24 months in people with SPMS [258]

doi:10.1056/NEJMoa2109794 McRae MP