skip to main content

AMAN — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardPeripheral Neuropathy & NeuromuscularAMANSCE Neurology

A patient with active secondary progressive multiple sclerosis is being considered for siponimod. Genotyping returns CYP2C9*3/*3. What should the multidisciplinary team conclude?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Siponimod is contraindicated because exposure is markedly increased in this genotype

Explanation lettering: C = shown as A · D = shown as B · B = shown as C · A = shown as D

D is correct: CYP2C9*3/*3 reduces siponimod clearance markedly and increases exposure by about 284%, so the SmPC contraindicates treatment. A ignores genotype-dependent dosing. B confuses *3/*3 with genotypes for which a 1 mg dose may be used. C and E invent unvalidated regimens and therapeutic monitoring. Genotyping is therefore a treatment-selection test, not merely an explanatory biomarker.

Reference: Mayzent 1 mg film-coated tablets SmPC: https://www.medicines.org.uk/emc/product/15328/smpc