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  • Title: Ozanimod: A Review in Relapsing Forms of Multiple Sclerosis.
    Author: Nie T, Syed YY.
    Journal: CNS Drugs; 2024 Nov; 38(11):931-941. PubMed ID: 39368032.
    Abstract:
    Ozanimod (Zeposia®), an orally administered sphingosine 1-phosphate (S1P) receptor modulator (S1PRM) that is selective for the S1P1 and S1P5 receptor subtypes, is approved in the USA for relapsing forms of multiple sclerosis (RMS). In pivotal phase III clinical trials in patients with RMS, ozanimod significantly reduced annualised relapse rates and the number of new or enlarging T2 lesions and gadolinium-enhancing lesions, and was associated with reduced brain volume loss, compared with interferon (IFN)-β1a. However, there were no significant differences in 3- and 6-month disability progression between the groups. Ozanimod was generally well tolerated, with the most common adverse reactions including upper respiratory tract infection and hepatic transaminase elevation. Efficacy and tolerability were sustained over more than 6 years with continued treatment. S1PRM-related adverse events seen with ozanimod are generally manageable with screening and/or monitoring. Notably, ozanimod does not require first-dose cardiac monitoring in the USA. In conclusion, ozanimod is a valuable once-daily oral disease-modifying therapy that extends the available treatment options for patients with RMS. In multiple sclerosis (MS), lymphocytes (a type of immune cell) are thought to enter the CNS and attack the myelin sheath surrounding neurons. Relapsing forms of MS (RMS) involve episodes of neurological dysfunction with complete or partial recovery. Sphingosine 1-phosphate (S1P) receptor modulators (S1PRMs) are an oral treatment for RMS that prevent the movement of lymphocytes from lymphoid tissues into peripheral blood and, therefore, into the CNS. Ozanimod (Zeposia®) is an S1PRM that is selective for the S1P1 and S1P5 receptor subtypes. In clinical trials in patients with RMS, ozanimod significantly reduced annualised relapse rates and disease activity as seen on MRI compared with interferon (IFN)-β1a; however, there were no differences in disability progression between the groups. Ozanimod was generally well tolerated; common adverse reactions included upper respiratory tract infection and hepatic transaminase elevation. Ozanimod requires screening and monitoring for certain adverse events that are associated with S1PRMs but does not require first-dose cardiac monitoring in the USA. In conclusion, ozanimod is a valuable once-daily oral disease-modifying therapy that extends the available treatment options for patients with RMS.
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