Therapeutics and Clinical Risk Management (Sep 2022)
A Literature Review of Ozanimod Therapy in Inflammatory Bowel Disease: From Concept to Practical Application
Abstract
Noah Becher,1 Arun Swaminath,2 Keith Sultan3 1Department of Medicine, Hofstra/Northwell Health at Staten Island University Hospital, Staten Island, NY, USA; 2Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA; 3Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USACorrespondence: Keith Sultan, Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 600 Northern Blvd Suite 111, Great Neck, New York, NY, 11021, USA, Tel +1 516-387-3990, Fax +1 516-387-3930, Email [email protected]: Inflammatory bowel disease (IBD), namely Ulcerative Colitis (UC) and Crohn’s Disease (CD), is believed to be due to a dysregulation of the innate immune response. The complexity of the immune cascade offers both a challenge and an opportunity to researchers seeking out new treatments for IBD, as various points along the inflammatory pathways can be targeted for interruption. Sphinogosine-1-phosphate (S1P) is a phospholipid molecule with wide ranging biological effects caused by binding five known S1P receptor subtypes. Ozanimod is a small molecule drug that selectively targets S1P receptors 1 and 5 which play a crucial role in lymphocyte trafficking. In clinical trials for both UC and CD, it has been shown to induce a reversible lymphopenia which correlates with response to therapy. Reported adverse events include infection, anemia, and elevated liver enzymes. Rare instances of bradycardia, heart block, and macular edema were also reported. As a newly available therapy approved for UC patients, we aim to summarize ozanimod’s novel mechanism of action, pre-clinical and clinical trial results, and to give context to this newly available drug that gastroenterologists may utilize in their treatment algorithm.Keywords: S1P modulator, ozanimod, inflammatory bowel disease, ulcerative colitis, IBD
