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Updated: Jan 22, 2026
09:41
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
12.0K
Pain outcomes in persons with multiple sclerosis receiving S1PR modulators: a cross-sectional study
Salvador Sierra1,2, Anna L Kratz3, Tiffany J Braley1
1Department of Neurology, University of Michigan, Ann Arbor, MI, United States.
Pain Medicine (Malden, Mass.)
|January 21, 2026
Summary
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.
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.
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