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Data in Early RMS: ENLIGHTEN Study

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ZEPOSIA was evaluated in 2 pivotal trials, SUNBEAM (1 year; N=1346) and RADIANCE (2 years; N=1313), that were multicenter, randomized, double-blind, double-dummy, active treatment-controlled studies of daily oral ozanimod 0.46 mg (not approved for maintenance dose) or 0.92 mg oral daily dose vs weekly Avonex (interferon beta-1a), 30-μg intramuscular injection. Please see study results below.1-3

The ENLIGHTEN Trial Is an Ongoing Post-Marketing Study Focused on Early RMS Patients4,5:

ENLIGHTEN Is an Ad Hoc, Open-Label, Single-Arm, Phase 3b/4, Ongoing Post-Marketing Study With 1-Year Interim Analysis* Results Presented at ECTRIMS 2023

ENLIGHTEN Study Design4,5

Graphic depicting the ENLIGHTEN Study Design Graphic depicting the ENLIGHTEN Study Design

Primary endpoint:

Clinically meaningful increase in cognitive processing speed, as measured by the SDMTa

Key secondary
endpoints:

  • Annual relapse rate
  • MRI lesions
  • Brain volume loss
  • Adverse events
Endpoints in the ENLIGHTEN study were analyzed descriptively.
Key Baseline Characteristics: 72.4% DMT naïve, 1.1 Mean years since RMS Diagnosis, 2.0 Median EDSS Key Baseline Characteristics: 72.4% DMT naïve, 1.1 Mean years since RMS Diagnosis, 2.0 Median EDSS
*Interim analysis period, data cutoff: February 14, 2023.4
aENLIGHTEN primary endpoint: proportion of patients with an increase in SDMT score ≥4 points or ≥10% from baseline to Year 1. The SDMT pairs a series of symbols with digits, and patients must match the appropriate symbol to the paired numerical digit using a key; the SDMT is administered orally in ENLIGHTEN. Scoring is based on the correct number of responses given in 90 seconds, with higher scores indicating faster processing.4

ENLIGHTEN Trial Inclusion Criteria1:

  • Aged 18-65 years at screening
  • Diagnosis of MS per the 2010 or 2017 revised McDonald criteria within the last 5 years
  • ≤1 MS disease-modifying therapy (none within 1 month of enrollment)
  • EDSS score of ≤3.5 at screening
  • No relapses within 30 days before screening
  • ≤10 GdE lesions on baseline brain MRI scan
  • No history of developmental disorders or motor or sensory defects that could interfere with cognitive test performance
ZEPOSIA pivotal trials SUNBEAM (1 year; N=1346) and RADIANCE (2 years; N=1313). Primary endpoint: ZEPOSIA reduced ARR vs Avonex by 48% at 1 year (0.181 vs 0.350, respectively) and by 38% at 2 years (0.172 vs 0.276, respectively). Secondary endpoints: ZEPOSIA reduced the number of new or enlarging T2 lesions by 48% at 1 year and by 42% at 2 years, and reduced the number of GdE lesions vs Avonex by 63% at 1 year and 53% at 2 years. 9 of 10 patients showed no confirmed 3-month disability progression. There was no significant difference in 3-month confirmed disability between ZEPOSIA and Avonex.1-3,7,8
ARR=annualized relapse rate; BVL=brain volume loss; DMT=disease-modifying therapy; EDSS=Expanded Disability Status Scale; GdE=gadolinium enhancing; MRI=magnetic resonance imaging; MS=multiple sclerosis; RMS=relapsing multiple sclerosis; SDMT=Symbol Digit Modalities Test.
Ad Hoc, Interim Analysis of Cognitive Processing Speed (SDMT) From ENLIGHTEN at 1 Year4

Patients Included in the Trial Had Been Diagnosed With MS for an Average of 1.1 Years6

Chart depicting Categorical Analysis of Cognitive Processing of Speed Data from ENLIGHTEN Chart depicting Categorical Analysis of Cognitive Processing of Speed Data from ENLIGHTEN

The SDMT assesses cognitive processing speed.9

In ENLIGHTEN, an SDMT score change of ≥4 points, or ≥10% from baseline, is considered clinically meaningful.4

Endpoints were analyzed descriptively.
bThe binary response (yes/no) to improvement in SDMT score was fitted on the observed data using a generalized estimating equation approach with a logit link including baseline SDMT value, baseline age, baseline whole brain volume, and time point (as a categorical variable).4
cImproved: at least a 4-point or 10% increase in SDMT relative to baseline; stable: change from baseline SDMT between −4 and 4 points and percentage change between −10% and 10%; worsened: at least a 4-point or 10% decrease in SDMT relative to baseline.4
In a post hoc analysis of SUNBEAM pivotal trial, 77% of patients on ZEPOSIA were categorized as improved or remained stable in SDMT scores at 1 year (23% of patients were categorized as worsened). Please note BVL and SDMT endpoints were not part of the statistical analysis hierarchy.1-3,7,8
Interim Analysis of Brain Volume Loss From ENLIGHTEN at 1 Year5

Patients Included in the Trial Had Been Diagnosed With MS for an Average of 1.1 Years6

Mean Percentage Change From Baseline (Interim Analysis)5

Chart depicting the mean percentage change from baseline (interim analysis) Chart depicting the mean percentage change from baseline (interim analysis)
Endpoints were analyzed descriptively.
In the ZEPOSIA pivotal trials, volume loss endpoints were measured as relative reduction in mean percent change from baseline vs Avonex at 1 year (SUNBEAM) and 2 years (RADIANCE); whole BVL, 31% and 26%; thalamic volume loss, 32% and 27%; and cortical grey matter volume loss, 84% and 60%, respectively.2,3
Adverse Events Reported in the ENLIGHTEN Trial in Patients With Early RMS at 1 Year of Treatment4

Chart depicting the incidence of avdverse events at Year 1 Chart depicting the incidence of avdverse events at Year 1
Chart depicting the incidence of avdverse events at Year 1 Chart depicting the incidence of avdverse events at Year 1

The safety profile for patients with early RMS is generally similar to
TEAEs observed in
pivotal trials2-4

Discontinuation rate
due to AEs
1.6%2-4*

*Discontinuation rates due to AEs in
pivotal trials were:
  • In SUNBEAM: 2.9% for ZEPOSIA and
    3.6% for Avonex
  • In RADIANCE: 3.0% for ZEPOSIA and
    4.1% for Avonex
dPandemic began at start of trial.
ZEPOSIA pivotal trials SUNBEAM (1 year; N=1346) and RADIANCE (2 years; N=1313) adverse reactions: Overall incidence of adverse reactions for ZEPOSIA vs Avonex at 1 year was 59.8% and 75.5%, respectively, and at 2 years was 74.7% and 83.0%, respectively. Across 2 head-to-head trials, the most common adverse reactions with an incidence of at least 2% in patients treated with ZEPOSIA and at least 1% greater than Avonex, respectively, were as follows: upper respiratory infection, 26% (vs 23%); hepatic transaminase elevation, 10% (vs 5%); orthostatic hypotension, 4% (vs 3%); urinary tract infection, 4% (vs 3%); back pain, 4% (vs 3%); hypertension, 4% (vs 2%); and upper abdominal pain, 2% (vs 1%). Data are not an adequate basis for comparison of rates between ZEPOSIA and the active control. Upper respiratory infection includes nasopharyngitis, upper respiratory tract infection, pharyngitis, respiratory tract infection, bronchitis, rhinitis, viral respiratory tract infection, viral upper respiratory tract infection, rhinorrhea, tracheitis, and laryngitis. Hepatic transaminase elevation includes alanine aminotransferase increased, gamma-glutamyl transferase increased, aspartate aminotransferase increased, hepatic enzyme increased, liver function test abnormal, and transaminase increased. Hypertension includes hypertension, essential hypertension, and orthostatic hypertension. Severe adverse reactions: the rate of severe adverse reactions at 1 year for ZEPOSIA was 1.6% vs 2.2% for Avonex and the rate at 2 years for ZEPOSIA was 3.5% vs 4.3% for Avonex. Serious adverse reactions: the rate of serious adverse reactions at 1 year for ZEPOSIA was 2.9% vs 2.5% for Avonex and the rate at 2 years for ZEPOSIA was 6.5% vs 6.4% for Avonex. Please see the full Prescribing Information for additional SUNBEAM and RADIANCE data.1-3,10
AE=adverse event.
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IMPORTANT SAFETY INFORMATION
Contraindications:
  • Patients who in the last 6 months, experienced myocardial infarction, unstable angina, stroke, transient ischemic attack (TIA), decompensated heart failure requiring hospitalization, or Class III/IV heart failure or have a presence of Mobitz type II second-degree or third-degree atrioventricular (AV) block, sick sinus syndrome, or sino-atrial block, unless the patient has a functioning pacemaker
  • Patients with severe untreated sleep apnea
  • Patients taking a monoamine oxidase (MAO) inhibitor
Infections: ZEPOSIA may increase the susceptibility to infections. Life-threatening and rare fatal infections have occurred in patients receiving ZEPOSIA. Obtain a recent (i.e., within 6 months or after discontinuation of prior MS or UC therapy) complete blood count (CBC) including lymphocyte count before initiation of ZEPOSIA. Delay initiation of ZEPOSIA in patients with an active infection until the infection is resolved. Consider interruption of treatment with ZEPOSIA if a patient develops a serious infection. Continue monitoring for infections up to 3 months after discontinuing ZEPOSIA.
  • Herpes zoster was reported as an adverse reaction in ZEPOSIA-treated patients. Herpes simplex encephalitis and varicella zoster meningitis have been reported with sphingosine 1-phosphate (S1P) receptor modulators. Patients without a healthcare professional-confirmed history of varicella (chickenpox), or without documentation of a full course of vaccination against varicella zoster virus (VZV), should be tested for antibodies to VZV before initiating ZEPOSIA. A full course of vaccination for antibody-negative patients with varicella vaccine is recommended prior to commencing treatment with ZEPOSIA.
  • Cases of fatal cryptococcal meningitis (CM) were reported in patients treated with another S1P receptor modulator. If CM is suspected, ZEPOSIA should be suspended until cryptococcal infection has been excluded. If CM is diagnosed, appropriate treatment should be initiated.
  • In the MS and UC clinical studies, patients who received ZEPOSIA were not to receive concomitant treatment with antineoplastic, non-corticosteroid immunosuppressive, or immune-modulating therapies used for treatment of MS and UC. Concomitant use of ZEPOSIA with any of these therapies would be expected to increase the risk of immunosuppression. When switching to ZEPOSIA from immunosuppressive medications, consider the duration of their effects and their mode of action to avoid unintended additive immunosuppressive effects.
  • Use of live attenuated vaccines should be avoided during and for 3 months after treatment with ZEPOSIA. If live attenuated vaccine immunizations are required, administer at least 1 month prior to initiation of ZEPOSIA.
Progressive Multifocal Leukoencephalopathy (PML): PML is an opportunistic viral infection of the brain that typically occurs in patients who are immunocompromised, and that usually leads to death or severe disability.

PML has been reported in patients treated with S1P receptor modulators, including ZEPOSIA, and other MS and UC therapies and has been associated with some risk factors. If PML is suspected, withhold ZEPOSIA and perform an appropriate diagnostic evaluation.

If confirmed, treatment with ZEPOSIA should be discontinued.

Immune reconstitution inflammatory syndrome (IRIS) has been reported in MS patients treated with S1P receptor modulators who developed PML and subsequently discontinued treatment. IRIS presents as a clinical decline in the patient’s condition that may be rapid, can lead to serious neurological complications or death, and is often associated with characteristic changes on MRI. The time to onset of IRIS in patients with PML was generally within a few months after S1P receptor modulator discontinuation. Monitoring for development of IRIS and appropriate treatment of the associated inflammation should be undertaken.

Bradyarrhythmia and Atrioventricular Conduction Delays: Since initiation of ZEPOSIA may result in a transient decrease in heart rate and atrioventricular conduction delays, dose titration is recommended to help reduce cardiac effects. Initiation of ZEPOSIA without dose escalation may result in greater decreases in heart rate. If treatment with ZEPOSIA is considered, advice from a cardiologist should be sought for those individuals:
  • with significant QT prolongation
  • with arrhythmias requiring treatment with Class 1a or III anti-arrhythmic drugs
  • with ischemic heart disease, heart failure, history of cardiac arrest or myocardial infarction, cerebrovascular disease, and uncontrolled hypertension
  • with a history of Mobitz type II second-degree or higher AV block, sick sinus syndrome, or sino-atrial heart block
Liver Injury: Elevations of aminotransferases may occur in patients receiving ZEPOSIA. Obtain liver function tests, if not recently available (i.e., within 6 months), before initiation of ZEPOSIA. Patients who develop symptoms suggestive of hepatic dysfunction should have hepatic enzymes checked and ZEPOSIA should be discontinued if significant liver injury is confirmed.
Fetal Risk: There are no adequate and well-controlled studies in pregnant women. Based on animal studies, ZEPOSIA may cause fetal harm. Women of childbearing potential should use effective contraception to avoid pregnancy during treatment and for 3 months after stopping ZEPOSIA. Women who become pregnant while taking ZEPOSIA for MS may enroll in the ZEPOSIA pregnancy registry by calling 1-877-301-9314 or visiting www.zeposiapregnancyregistry.com.
Increased Blood Pressure: Increase in systolic pressure was observed after about 3 months of treatment and persisted throughout treatment. Blood pressure should be monitored during treatment and managed appropriately. Certain foods that may contain very high amounts of tyramine could cause severe hypertension in patients taking ZEPOSIA. Patients should be advised to avoid foods containing a very large amount of tyramine while taking ZEPOSIA.
Respiratory Effects: ZEPOSIA may cause a decline in pulmonary function. Spirometric evaluation of respiratory function should be performed during therapy, if clinically indicated.
Macular Edema: S1P modulators have been associated with an increased risk of macular edema. Patients with a history of uveitis or diabetes mellitus are at increased risk. Patients with a history of these conditions should have an ophthalmic evaluation of the fundus, including the macula, prior to treatment initiation and regular follow-up examinations. An ophthalmic evaluation is recommended in all patients at any time if there is a change in vision. Continued use of ZEPOSIA in patients with macular edema has not been evaluated; potential benefits and risks for the individual patient should be considered if deciding whether ZEPOSIA should be discontinued.
Posterior Reversible Encephalopathy Syndrome (PRES): Rare cases of PRES have been reported in patients receiving a S1P receptor modulator. If a ZEPOSIA-treated patient develops unexpected neurological or psychiatric symptoms or any symptom/sign suggestive of an increase in intracranial pressure, a complete physical and neurological examination should be conducted. Symptoms of PRES are usually reversible but may evolve into ischemic stroke or cerebral hemorrhage. Delay in diagnosis and treatment may lead to permanent neurological sequelae. If PRES is suspected, treatment with ZEPOSIA should be discontinued.
Unintended Additive Immunosuppressive Effects From Prior Immunosuppressive or Immune-Modulating Drugs: When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects while at the same time minimizing risk of disease reactivation. Initiating treatment with ZEPOSIA after treatment with alemtuzumab is not recommended.
Severe Increase in Multiple Sclerosis (MS) Disability After Stopping ZEPOSIA: In MS, severe exacerbation of disease, including disease rebound, has been rarely reported after discontinuation of a S1P receptor modulator. The possibility of severe exacerbation of disease should be considered after stopping ZEPOSIA treatment so patients should be monitored upon discontinuation. After stopping ZEPOSIA in the setting of PML, monitor for development of immune reconstitution inflammatory syndrome (PML-IRIS).
Immune System Effects After Stopping ZEPOSIA: After discontinuing ZEPOSIA, the median time for lymphocyte counts to return to the normal range was 30 days with approximately 90% of patients in the normal range within 3 months. Use of immunosuppressants within this period may lead to an additive effect on the immune system, therefore caution should be applied when initiating other drugs 4 weeks after the last dose of ZEPOSIA.
Most Common Adverse Reactions that occurred in the MS clinical trials of ZEPOSIA-treated patients (≥4%): upper respiratory infection, hepatic transaminase elevation, orthostatic hypotension, urinary tract infection, back pain, and hypertension.

In the UC clinical trials, the most common adverse reactions that occurred in ≥4% of ZEPOSIA-treated patients and greater than in patients who received placebo were upper respiratory infection, liver test increased, and headache.

Use in Specific Populations: Hepatic Impairment: Dosage adjustment in patients with mild or moderate hepatic impairment (Child-Pugh class A or B) is required, and use of ZEPOSIA in patients with severe hepatic impairment (Child-Pugh class C) is not recommended.
For additional safety information, please see the full Prescribing Information and Medication Guide.
INDICATIONS
ZEPOSIA® (ozanimod) is indicated for the treatment of:
  1. Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
  2. Moderately to severely active ulcerative colitis (UC) in adults.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Comi G, Kappos L, Selmaj KW, et al; SUNBEAM Study Investigators. 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(11):1009-1020 and Suppl 1-26.
  3. Cohen JA, Comi G, Selmaj KW, et al; RADIANCE Trial Investigators. 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(11):1021-1033 and Suppl 1-31.
  4. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: final analysis of the DAYBREAK open-label extension study. Poster presented at: ACTRIMS 2024 Forum; February 29–March 2, 2024; West Palm Beach, FL. Poster P090.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Comi G, Kappos L, Selmaj KW, et al; SUNBEAM Study Investigators. 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(11):1009-1020 and Suppl 1-26.
  3. Cohen JA, Comi G, Selmaj KW, et al; RADIANCE Trial Investigators. 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(11):1021-1033 and Suppl 1-31.
  4. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: final analysis of the DAYBREAK open-label extension study. Poster presented at: ACTRIMS 2024 Forum; February 29–March 2, 2024; West Palm Beach, FL. Poster P090.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: final analysis of the DAYBREAK open-label extension study. Poster presented at: ACTRIMS 2024 Forum; February 29–March 2, 2024; West Palm Beach, FL. Poster P090.
  3. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis in DAYBREAK: an open-label extension study of ozanimod phase 1-3 trials. Presented at: 8th Joint ACTRIMS-ECTRIMS Meeting; September 11–13, 2020; MSVirtual2020. Presentation P0217.
  4. Cree BAC, Selmaj KW, Steinman L, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: up to 5 years of follow-up in the DAYBREAK open-label extension trial. Mult Scler. 2022;28(12):1944-1962.
  5. Comi G, Kappos L, Selmaj KW, et al; SUNBEAM Study Investigators. 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(11): 1009-1020 and Suppl 1-26.
  6. Cohen JA, Comi G, Selmaj KW, et al; RADIANCE Trial Investigators. 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(11):1021-1033 and Suppl 1-31.
  7. Centonze D, Hartung HP, Montalbán X, et al. Long-term efficacy of ozanimod in disease-modifying treatment-naive vs experienced patients with relapsing multiple sclerosis. Poster presented at: ACTRIMS 2024 Forum; February 29–March 2, 2024; West Palm Beach, FL. Poster P092.
  8. DeLuca J, Cohen JA, Cree BAC, et al. Effects of ozanimod on cognitive processing speed: updated findings from the phase 3 SUNBEAM and DAYBREAK extension trials. Poster presented at: ACTRIMS 2024 Forum; February 29–March 2, 2024; West Palm Beach, FL. Poster P353.
  9. Polman CH, Rudick RA. The multiple sclerosis functional composite: a clinically meaningful measure of disability. Neurology. 2010;74(suppl 3):S8-S15.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Efficacy and safety study of ozanimod in ulcerative colitis (Touchstone). Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT01647516. Updated May 19, 2021. Accessed July 26, 2023.
  3. Study of ozanimod (RPC1063) in relapsing multiple sclerosis (MS) (SUNBEAM). Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT02294058. Updated November 25, 2020. Accessed July 26, 2023.
  4. Efficacy and safety study of ozanimod in relapsing multiple sclerosis (RADIANCE). Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT02047734. Updated February 11, 2021. Accessed July 26, 2023.
  5. Efficacy and safety study of ozanimod (RPC1063) in relapsing multiple sclerosis patients (RADIANCE). Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT01628393. Updated November 2, 2021. Accessed September 6, 2023.
  6. Sandborn WJ, Feagan BG, D’Haens G, et al; True North Study Group. Ozanimod as induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2021;385(14):1280-1291.
  7. Safety and efficacy trial of RPC1063 for moderate to severe ulcerative colitis. Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT02435992. Updated September 1, 2021. Accessed July 26, 2023.
  8. An extension study of RPC1063 as therapy for moderate to severe ulcerative colitis. Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT02531126. Updated September 18, 2023. Accessed September 25, 2023.
  9. A multi-site, open-label extension trial of oral RPC1063 in relapsing multiple sclerosis. Clinicaltrials.gov. https://clinicaltrials.gov/study/NCT02576717. Updated March 13, 2023. Accessed July 26, 2023.
  10. Data on File. BMS-REF-OZA-0038. Princeton, NJ: Bristol-Myers Squibb Company; 2023.
  11. Data on File. BMS-REF-OZA-0039. Princeton, NJ: Bristol-Myers Squibb Company; 2023.
  12. Danese S, Abreu MT, Wolf DC, et al. Efficacy and safety of 3 years of continuous ozanimod treatment: an interim analysis of the True North open-label extension study. Oral presentation at: European Crohn’s and Colitis Organisation (ECCO) 2023: March 1-4, 2023; Copenhagen, Denmark. Presentation DOP37.
  13. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: final analysis of the DAYBREAK open-label extension study. Poster presented at: ACTRIMS 2024 Forum; February 29–March 2, 2024; West Palm Beach, FL. Poster P090.
  14. Comi G, Kappos L, Selmaj KW, et al; SUNBEAM Study Investigators. 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(11):1009-1020 and Suppl 1-26.
  15. Cohen JA, Comi G, Selmaj KW, et al; RADIANCE Trial Investigators. 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(11):1021-1033 and Suppl 1-31.
  16. Lymphocytopenia. National Heart, Lung, and Blood Institute (NHLBI). www.nhlbi.nih.gov/health-topics/lymphocytopenia. Accessed June 7, 2022.
  17. Steinman L, Comi G, Bar-Or A, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: results from the DAYBREAK open-label extension study. Poster presented at: 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); September 11–13, 2019; Stockholm, Sweden. Poster P1031.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Scott FL, Clemons B, Brooks J, et al. Ozanimod (RPC1063) is a potent sphingosine-1-phosphate receptor-1 (S1P1) and receptor-5 (S1P5) agonist with autoimmune disease-modifying activity. Br J Pharmacol. 2016;173(11):1778-1792.
  3. Spiegel S, Milstien S. The outs and the ins of sphingosine-1-phosphate in immunity. Nat Rev Immunol. 2011;11(6):403-415.
  4. Choi JW, Gardell SE, Herr DR, et al. FTY720 (fingolimod) efficacy in an animal model of multiple sclerosis requires astrocyte sphingosine 1-phosphate receptor 1 (S1P1) modulation. Proc Natl Acad Sci USA. 2011;108(2):751-756.
  5. Peyrin-Biroulet L, Christopher R, Behan D, Lassen C. Modulation of sphingosine-1-phosphate in inflammatory bowel disease. Autoimmun Rev. 2017;16(5):495-503.
  6. Sanna MG, Vincent KP, Repetto E, et al. Bitopic sphingosine 1-phosphate receptor 3 (S1P3) antagonist rescue from complete heart block: pharmacological and genetic evidence for direct S1P3 regulation of mouse cardiac conduction. Mol Pharmacol. 2016;89(1):176-186.
  7. O'Sullivan S, Dev KK. Sphingosine-1-phosphate receptor therapies: advances in clinical trials for CNS-related diseases. Neuropharmacology. 2017;113(Pt B):597-607.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Marrie RA. Comorbidity in multiple sclerosis: implications for patient care. Nat Rev Neurol. 2017;13(6):375-382.
References:
  1. Zeposia. Prescribing Information. Bristol-Myers Squibb Company; 2023.
  2. Comi G, Kappos L, Selmaj KW, et al; SUNBEAM Study Investigators. 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(11): 1009-1020 and Suppl 1-26.
  3. Cohen JA, Comi G, Selmaj KW, et al; RADIANCE Trial Investigators. 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(11):1021-1033 and Suppl 1-31.
  4. Naismith RT, Zivadinov R, Morrow SA, et al. Safety and efficacy of ozanimod over 1 year in patients with early relapsing multiple sclerosis: an interim analysis of the ENLIGHTEN study. Presented at the 9th Joint ECTRIMS-ACTRIMS Meeting; October 11–13, 2023; Milan, Italy. Poster P690.
  5. Zivadinov R, Naismith RT, Morrow SA, et al. Brain volume changes over 1 year in ozanimod-treated patients with early relapsing multiple sclerosis: an interim analysis of the ENLIGHTEN study. Presented at the 9th Joint ECTRIMS-ACTRIMS Meeting; October 11–13, 2023; Milan, Italy. Poster P1311.
  6. Data on File. BMS-REF-OZA-0065. Princeton, NJ: Bristol-Myers Squibb Company; 2023.
  7. DeLuca J, Cohen JA, Cree BAC, et al. Effects of ozanimod on cognitive processing speed: findings from the phase 3 SUNBEAM and DAYBREAK extension trials. Presented at: ACTRIMS 2023 Forum; February 23–25, 2023; San Diego, CA. Presentation 074.
  8. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis in DAYBREAK: an open-label extension study of ozanimod phase 1-3 trials. Presented at: 8th Joint ACTRIMS-ECTRIMS Meeting; September 11–13, 2020; MSVirtual2020. Presentation P0217.
  9. Benedict RH, DeLuca J, Phillips G, et al. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Mult Scler. 2017;23(5);721–733.
  10. Selmaj KW, Steinman L, Comi G, et al. Long-term safety and efficacy of ozanimod in relapsing multiple sclerosis: interim analysis of the DAYBREAK open-label extension study. Poster presented at: 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); October 26–28 2022; hybrid conference; Amsterdam, Netherlands. Poster P334.
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