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    • Has all of the relevant evidence been taken into account?

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1 Recommendations

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1 Recommendations

1.1 Ponesimod is not recommended, within its marketing authorisation, for treating relapsing forms of multiple sclerosis with active disease defined by clinical or imaging features in adults.

1.2 This recommendation is not intended to affect treatment with ponesimod that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

Treatments for relapsing multiple sclerosis include many disease-modifying treatments. These aim to reduce the number of relapses, slow the progression of disability, and maintain or improve quality of life.

Clinical trial evidence shows that ponesimod reduces the number of relapses compared with teriflunomide. However, ponesimod's effect on disability progression is unclear. Comparisons with other disease-modifying treatments are limited by uncertainties in the clinical evidence.

The cost-effectiveness estimates are uncertain because of limitations in the clinical evidence and how long-term clinical benefit is predicted from short-term evidence. The estimates are above what NICE normally considers an acceptable use of NHS resources. Therefore, ponesimod is not recommended.