Siponimod (Mayzent®) is an oral selective sphingosine 1-phosphate receptor 
subtypes 1 and 5 (S1PR1,5) modulator being developed by Novartis Pharmaceuticals 
for the treatment of multiple sclerosis (MS) and intracerebral haemorrhage. In 
March 2019, siponimod received its first global approval in the USA, for the 
treatment of adults with relapsing forms of MS, including clinically isolated 
syndrome, relapsing-remitting disease and active secondary progressive disease. 
Siponimod is under regulatory review in the EU and Japan for secondary 
progressive MS. This article summarizes the milestone in the development of 
siponimod leading to this first global approval for MS in the USA.