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Pain outcomes in persons with multiple sclerosis receiving S1PR modulators: a cross-sectional study.

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Sphingosine-1-phosphate receptor (S1PR) modulators may reduce nociplastic pain intensity in multiple sclerosis (MS) patients. This study compared S1PR modulators to other disease-modifying therapies (DMTs) for MS pain management.

Keywords:
Central sensitizationMultiple sclerosisNociplastic painS1PR modulators

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Area of Science:

  • Neurology
  • Immunology
  • Pain Medicine

Background:

  • The efficacy of disease-modifying therapies (DMTs) in managing chronic pain in multiple sclerosis (MS) remains unclear.
  • Preclinical studies suggest sphingosine-1-phosphate (S1P) pathway modulation may offer analgesic effects beyond MS relapse prevention.

Purpose of the Study:

  • To compare pain phenotypes, severity, and treatments in persons with MS (PwMS) using S1PR modulators versus other DMTs.
  • Investigate the association between S1PR modulator use and specific pain characteristics in MS.

Main Methods:

  • Secondary analysis of cross-sectional data from a nationwide MS survey.
  • Univariate analyses (t-tests, chi-square tests) examined associations between DMT class, demographics, disability, MS duration, and pain outcomes.
  • Pain phenotypes assessed using painDETECT and ACR/EULAR criteria; intensity and interference via PROMIS scales.

Main Results:

  • 82 of 731 participants used S1PR modulators; users were younger but otherwise similar to other DMT users.
  • No significant differences in pain types were observed between groups after age adjustment.
  • PwMS with nociplastic pain using S1PR modulators reported significantly lower pain intensity (p=0.02).

Conclusions:

  • S1PR modulators are associated with reduced pain intensity in MS patients experiencing nociplastic pain.
  • Findings suggest a potential role for S1PR modulators in managing specific pain types in MS.
  • Further clinical research is warranted to confirm these analgesic effects.