Nursing: Research and Reviews (Feb 2024)
Ozanimod: A Practical Review for Nurses and Advanced Practice Providers
Abstract
Michele Rubin,1 Christen Kutz2 1Department of Colorectal Surgery, University of Chicago IBD Center, Joliet, IL, USA; 2Colorado Springs Neurological Associates, Colorado Springs, CO, USACorrespondence: Michele Rubin, Associate Director of IBD Center, University of Chicago IBD Center, 2914 Hintze Court, Joliet, IL, 60435, USA, Tel +1-815-347-8307, Fax +1-773-834-1995, Email [email protected]: Ozanimod is the first sphingosine 1-phosphate (S1P) receptor modulator approved for the treatment of moderately to severely active ulcerative colitis (UC). In clinical trials, participants with moderately to severely active UC who received once-daily oral ozanimod demonstrated significantly improved rates of clinical, endoscopic, and histologic outcomes than participants receiving placebo. Ozanimod is also approved for the treatment of relapsing forms of multiple sclerosis (MS). This review summarizes safety data from UC and MS clinical trials and discusses treatment considerations when using ozanimod in clinical practice. Ozanimod is an oral, small molecule agent with a novel mechaism of action that differentiates it from other UC therapies. Ozanimod was generally well tolerated in clinical trials, and the incidence of adverse events of special interest based on prior associations with S1P receptor modulation was low overall. Of note, the risk for clinically significant bradycardia upon treatment initiation was mitigated by gradual dose titration, few patients experienced lymphopenia or serious infections, macular edema and malignancy occurred infrequently, and most hepatic events were transient and did not require treatment discontinuation. Given the safety and efficacy profile of ozanimod, it may be an early treatment option in patients with moderate disease or in those hesitant to use biologics, and it could also be beneficial after other treatments have failed. Further investigation is needed to determine the positioning of ozanimod within the UC treatment armamentarium.Plain Language Summary: This article provides information about the use of ozanimod in treating patients with moderately to severely active ulcerative colitis (UC) and offers practical guidance for nurses, nurse practitioners, and other healthcare providers to help address questions that may come up in clinical practice. Ozanimod is an oral medication that improves UC symptoms as well as current biologics, while also reducing the need for corticosteroids, a key aspect in treating UC. Ozanimod may be used either after a patient has failed a biologic or as an early treatment option before starting a biologic in patients with moderate UC who may be hesitant to start biologics. This article includes tools to help guide clinical practice decision-making, educate on possible adverse events, and provide the monitoring necessary to ensure patient safety and best practices in the use of ozanimod.Keywords: ulcerative colitis, ozanimod, sphingosine 1-phosphate, safety
