Efficacy and safety of ozanimod for ulcerative colitis (review)
https://doi.org/10.33878/2073-7556-2022-21-3-119-129
Abstract
Ulcerative colitis is a chronic autoimmune bowel disease that currently has no complete cure other than surgery. The use of various agents in a number of patients is ineffective or leads to certain adverse events that require a change in therapy. There is an unmet need for new agents that are fundamentally different in mechanism of action, but show high efficacy and safety. Ozanimod, being a sphingosine-1-phosphate receptor modulator, prevents lymphocyte entry, thereby reducing inflammation in the gut. This article presents a review of data on the mechanism of action of this drug, its efficacy and safety in the treatment of ulcerative colitis, both in bionaive patients and those who have not responded to treatment with other biological drugs.
About the Authors
M. V. ShapinaRussian Federation
Marina V. Shapina
Salyama Adilya str., 2, Moscow, 123423
A. V. Poletova
Russian Federation
Anna V. Poletova
Salyama Adilya str., 2, Moscow, 123423
T. A. Baranova
Russian Federation
Tatyana A. Baranova
Salyama Adilya str., 2, Moscow, 123423
References
1. Ivashkin V.T., Shelygin Yu.A., Belousova E.A., et al. Project: clinical guidelines for the diagnostics and treatment of ulcerative colitis. Koloproktologia. 2019;18(4):7–36. (in Russ.). doi: 10.33878/2073-7556-2019-18-4-7-36
2. Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019;114:384–413.
3. Danese S, Allez M, van Bodegraven AA, et al. Unmet medical needs in ulcerative colitis: an expert group consensus. Dig Dis. 2019;37:266–83.
4. Narang V, Kaur R, Garg B, et al. Association of endoscopic and histological remission with clinical course in patients of ulcerative colitis. Intest Res. 2018;16:55–61.
5. Moss AC, Brinks V, Carpenter JF. Review article: Immunogenicity of anti-TNF biologics in IBD — the role of patient, product and prescriber factors. Aliment Pharmacol Ther. 2013;38:1188–97.
6. Thomas SS, Borazan N, Barroso N, et al. Comparative immunogenicity of TNF inhibitors: impact on clinical efficacy and tolerability in the management of autoimmune diseases. A systematic review and meta-analysis. Bio Drugs. 2015;29:241–58.
7. Fine S, Papamichael K, Cheifetz AS. Etiology and management of lack or loss of response to anti-tumor necrosis factor therapy in patients with inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2019;15:656–65.
8. Sandborn WJ, Panés J, Sands BE, et al. Venous thromboembolic events in the tofacitinib ulcerative colitis clinical development programme. Aliment Pharmacol Ther. 2019;50:1068–76.
9. D’Amico F, Parigi TL, Fiorino G, Peyrin-Biroulet L, et al. Tofacitinib in the treatment of ulcerative colitis: efficacy and safety from clinical trials to real-world experience. Therap Adv Gastroenterol. 2019 May 16;12:1756284819848631. doi: 10.1177/1756284819848631
10. Scott FL, Clemons B, Brooks J, et al. Ozanimod (RPC1063) is potent sphingosine-1-phosphate receptor-1 (S1P1) and receptor-5 (S1P5) agonist with autoimmune disease-modifying activity. Br J Pharmacol. 2016;173:1778–92
11. Tran JQ, Zhang P, Surapeni S, Selkirk J, et al. Absorption, metabolism, and excretion, in vitro pharmacology, and clinical pharmacokinetics of ozanimod, a novel sphingosine 1-phosphate receptor agonist. Presented at the Annual Meeting of the European Committee for Treatment and Research in Multiple Sclerosis, Stockholm, September 11–13, 2019. Abstract.
12. Matloubian M, Lo CG, Cinamon G, et al. Lymphocyte egress from thymus and peripheral lymphoid organs is dependent on S1P receptor 1. Nature. 2004;427:355–60.
13. Kappos L, Radue EW, O’Connor P, et al. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med. 2010;362:387–401.
14. Kappos L, Bar-Or A, Cree BAC, et al. Siponimod versus placebo in secondary progressive multiple sclerosis (expand): a double-blind, randomised, phase 3 study. Lancet. 2018;391:1263–73.
15. Cohen JA, Arnold DL, Comi G, et al. Safety and efficacy of the selective sphingosine 1-phosphate receptor modulator ozanimod in relapsing multiple sclerosis (radiance): a randomised, placebo-controlled, phase 2 trial. Lancet Neurol. 2016;15:373–81.
16. Cohen JA, Comi G, Selmaj KW, et al. Safety and efficacy of ozanimod versus interferon beta-1a in relapsing multiple sclerosis (radiance): a multicentre, randomised, 24-month, phase 3 trial. Lancet Neurol. 2019;18:1021–33.
17. Pérez-Jeldres T, Tyler CJ, Boyer JD, et al. Targeting cytokine signaling and lymphocyte traffic via small molecules in inflammatory bowel disease: JAK inhibitors and S1PR agonists. Front Pharmacol. 2019;10:212.
18. Sukocheva OA, Lukina E, McGowan E, Bishayee A. Sphingolipids as mediators of inflammation and novel therapeutic target in inflammatory bowel disease. Adv Protein Chem Struct Biol. 2020;120:123–58.
19. Brinkmann V. Sphingosine 1-phosphate receptors in health and disease: mechanistic insights from gene deletion studies and reverse pharmacology. Pharmacol Ther. 2007;115:84–105
20. Martin R, Sospedra M. Sphingosine-1 phosphate and central nervous system. Curr Top Microbiol Immunol. 2014;378:149–70.
21. Groves A, Kihara Y, Chun J. Fingolimod: direct CNS effects of sphingosine 1-phosphate (S1P) receptor modulation and implications in multiple sclerosis therapy. J Neurol Sci. 2013;328:9–18.
22. Rivera J, Proia RL, Olivera A. The alliance of sphingosine1-phosphate and its receptors in immunity. Nat Rev Immunol. 2008;8(10):753–63.
23. Karuppuchamy T, Tyler CJ, Lundborg LR, et al. Sphingosine-1-phosphate lyase inhibition alters the S1P gradient and amelio- rates Crohn’s-like ileitis by suppressing thymocyte maturation. Inflamm Bowel Dis. 2020;26(2):216–28.
24. Mullershausen F, Zerci F, Cetin C, et al. Persistent signaling induced by FTY720-phosphate is mediated by internalized S1P1 receptors. Nat Chem Biol. 2009;5(6):428–34.
25. Sandborn WJ, Feagan BG, D’Haens G, et al. Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med. 2021;385:1280–91.
26. Sandborn WJ, Feagan BG, Hanauer S, et al. Long-Term Efficacy and Safety of Ozanimod in Moderately to Severely Active Ulcerative Colitis: Results From the Open-Label Extension of the Randomized, Phase 2 TOUCHSTONE Study. Journal of Crohn’s and Colitis. 2021;15(7):1120–1129.
27. Eaton K, Duperrouzel C, Bhandari P, et al. Ozanimod for induction treatment of Moderate-to-Severe Ulcerative Colitis: Results from a systematic literature review and network meta-analyses. Abstracts of the 16th Congress of ECCO — European Crohn’s and Colitis Organisation. DOP69:S103.
28. Lasa JS, Olivera PA, Danese S, Peyrin-Biroulet L. Efficacy and safety of biologics and small molecule drugs for patients with moderate-to-severe ulcerative colitis: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2022 Feb;7(2):161–170.
29. D’Haens G, Colombel JF, Lichtenstein GR, et al. Safety of ozanimod in patients with moderately to severely active ulcerative colitis over time: pooled analysis from phase 2, phase 3, and open-label extension trials. Oral presentation at: DDW 2021 Virtual Digestive Disease Week; May 21–23, 2021.
30. Jangi S, Yoon H, Dulai PS, et al. Predictors and outcomes of histological remission in ulcerative colitis treated to endoscopic healing. Aliment Pharmacol Ther. 2020;52:1008–16.
31. Pai RK, Hartman DJ, Rivers CR, et al. Complete resolution of mucosal neutrophils associates with improved long-term clinical outcomes of patients with ulcerative colitis. Clin Gastroenterol Hepatol. 2020;18(11):2510.e5-2517.e5.
32. Juif PE, Kraehenbuehl S, Dingemanse J. Clinical pharmacology, efficacy, and safety aspects of sphingosine-1-phosphate receptor modulators. Expert Opin Drug Metab Toxicol. 2016 Aug;12(8):879–95. Epub 2016 Jun 13. doi: 10.1080/17425255.2016.1196188
33. Harris S, Tran JQ, Southworth H. Effect of the sphingosine1-phosphate receptor modulator ozanimod on leukocyte subtypes in relapsing MS. Neurology: Neuroimmunology & Neuroinflammation. 2020;7(5):1–10. doi: 10.1212/NXI.0000000000000839
34. Danese S, et al. Long-term safety of ozanimod in patients with moderately to severely active ulcerative colitis (UC) and relapsing multiple sclerosis (MS) studies. UEGW. 2021; Poster Number P0442.
35. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis in DAYBREAK: an openlabel extension study of ozanimod phase 1−3 trials. Presented at the Triennial Joint Meeting of the European and Americas Committees for Treatment and Research in Multiple Sclerosis (MSVirtual2020), September 11–13, 2020.
36. Comi G, Kappos L, Selmaj KW, et al. Safety and efficacy of ozanimod versus interferon beta-1a in relapsing multiple sclerosis (SUNBEAM): a multicentre, randomised, minimum 12-month, phase 3 trial. Lancet Neurol. 2019;18:1009–20.
37. Cohen JA, Comi G, Selmaj KW, et al. Safety and efficacy of ozanimod versus interferon beta-1a in relapsing multiple sclerosis (RADIANCE): a multicentre, randomised, 24-month, phase 3 trial. Lancet Neurol. 2019;18:1021–33.
38. Lamb YN. Ozanimod: first approval. Drugs. 2020;80:841–8.
Review
For citations:
Shapina M.V., Poletova A.V., Baranova T.A. Efficacy and safety of ozanimod for ulcerative colitis (review). Koloproktologia. 2022;21(3):119-129. https://doi.org/10.33878/2073-7556-2022-21-3-119-129