aZEPOSIA has been studied across multiple indications in 4 clinical trials, including TRUE NORTH (Ph 3); TOUCHSTONE (Ph 2); and SUNBEAM (Ph 3) and RADIANCE (Ph 3). 496 patients receiving the 0.92-mg dose of ZEPOSIA during induction in TRUE NORTH or TOUCHSTONE and 882 patients receiving the 0.92-mg dose of ZEPOSIA in SUNBEAM or RADIANCE were assessed in the safety analysis.1
bMS: Includes Phase 1, Phase 2, SUNBEAM, RADIANCE, and DAYBREAK (data cutoff: February 2, 2021). UC: Includes TOUCHSTONE, TRUE NORTH, TRUE NORTH OLE (data cutoff: September 30, 2020). Post-marketing Setting: data cutoff November 19, 2021. Exposure for patients with MS in clinical trials is 2631 patients and 11,938 patient-years. Exposure for patients with UC in clinical trials is 1158 patients and 2108 patient-years. Exposure for patients in the post-marketing setting across indications is 9738 patients and 6455 patient-years2-4
Upper Respiratory Infectiond | 5% | 4% |
Liver Test Increasede | 5% | 0% |
Headache | 4% | 3% |
Pyrexia | 3% | 2% |
Nausea | 3% | 2% |
Arthralgia | 3% | 1% |
UC Study 3 (8-week induction): TOUCHSTONE is a Phase 2, multi-center, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the clinical efficacy and safety of induction therapy with RPC1063 in 199 patients with moderately to severely active ulcerative colitis. Participants who completed the induction period and were responders at Week 8 continued to receive the same dose of ozanimod during the maintenance period up to Week 32.
For full study design of UC Study 1 and Study 2, click here.
Adverse Event | 40.1% | 38% |
Serious Adverse Event | 4% | 3.2% |
Liver Test Increasedh | 11% | 2% |
Headache | 5% | <1% |
Adverse Event | 49.1% | 36.6% |
Serious Adverse Event | 5.2% | 7.9% |
MS=multiple sclerosis; OLE=open-label extension; UC=ulcerative colitis.
ZEPOSIA 0.92 mg (n=429) |
Placebo (n=216) |
ZEPOSIA 0.92 mg (n=230) |
Placebo (n=227) |
|
---|---|---|---|---|
ALT ≥3x ULN |
2.6% | 0.5% | 2.3% | 0% |
ALT ≥5x ULN |
0.9% | 0.5% | 0.9% | 0% |
ALT=alanine aminotransferase; LFT=liver function test; UC=ulcerative colitis; ULN=upper limit of normal.
In controlled clinical trials with ZEPOSIA, mean lymphocyte counts decreased to approximately 45% of baseline at 3 months (approximate mean blood lymphocyte counts 0.8 x 109/L), and low lymphocyte counts were maintained during treatment with ZEPOSIA.1
ALC=absolute lymphocyte count; OLE=open-label extension; UC=ulcerative colitis.
UC Study 1—Induction:
6.5% for ZEPOSIA | 11.1% for Placebo
UC Study 2—Maintenance:
20.0% for ZEPOSIA | 45.4% for Placebo
Induction
3.3%
ZEPOSIA
vs 3.2%
for placebo
Maintenance
1.3%
ZEPOSIA
vs 2.6%
for placebo
One case of macular edema was reported during the maintenance phase in 1 person with preexisting risk factors at baseline; it resolved after discontinuation of treatment.1,8
Overall, the discontinuation rate because of elevations in hepatic enzymes was 0.4% in patients treated with ZEPOSIA 0.92 mg and none in patients who received placebo in the controlled UC studies.1
TEAEs=treatment-emergent adverse events; UC=ulcerative colitis.
Infection |
ZEPOSIA 0.92 mg (n=496) |
Placebo (n=281) |
ZEPOSIA 0.92 mg (n=230) |
Placebo (n=227) |
---|---|---|---|---|
Overall Rate of Infection |
9.9% | 10.7% | 23% | 12% |
Serious Infections |
0.8% | 0.4% | 0.9% | 1.8% |
Herpes Zoster |
0.4% | 0% | 2.2% | 0.4% |
Malignancies Malig- nancies |
ZEPOSIA 0.92 mg (n=429) |
Placebo (n=216) |
ZEPOSIA 0.92 mg (n=230) |
Placebo (n=227) |
---|---|---|---|---|
Basal Cell Carcinoma |
0% | 0% | 0.4% | 0% |
Rectal Adenocar- cinoma |
0% | 0% | 0.4% | 0% |
Adenocar- cinoma of the Colon |
0% | 0% | 0% | 0.4% |
Breast Cancer |
0% | 0% | 0% | 0.4% |
% (n) | IR, per 100 PYn | % (n) | IR, per 100 PYn | |
---|---|---|---|---|
Any Infection |
29.1 (337) | 22.81 | 14.0 (71) | 31.43 |
Any Serious Infection |
2.2 (25) | 1.32 | 1.4 (7) | 2.84 |
Malignan- cies |
1.0 (12) | 0.63 | 0.4 (2) | 0.81 |
IR=incidence rate; OLE=open-label extension; PT=preferred term; PY=patient-years; S1P=sphingosine 1-phosphate; SOC=system organ class; UC=ulcerative colitis.
OLE safety in TRUE NORTH patients who had up to 146 weeks of ZEPOSIA exposure
TEAEs | 81.7 (672) | 87.6 |
---|---|---|
Serious TEAEs | 18.1 (149) | 7.4 |
TEAEs Leading to Discontinuation of ZEPOSIA |
6.7 (55) | 2.5 |
Most Frequent TEAEs (Occurring in ≥5% of Patients) | ||
Lymphopeniaq | 15.6 (128) | 6.4 |
Anemiaq | 10.4 (86) | 4.2 |
Nasopharyngitis | 10.3 (85) | 4.1 |
Lymphocyte Count Decreasedq | 10.2 (84) | 4.0 |
Alanine Aminotransferase Increasedq | 9.0 (74) | 3.6 |
Arthralgia | 9.0 (74) | 3.6 |
COVID-19 | 8.0 (66) | 3.0 |
Headache | 7.7 (63) | 3.0 |
Upper Respiratory Tract Infection | 6.8 (56) | 2.7 |
Gamma-glutamyl Transferase Increasedq | 6.6 (54) | 2.6 |
Hypertension | 6.0 (49) | 2.3 |
UC Exacerbation | 5.3 (44) | 2.0 |
Cough | 5.1 (42) | 2.0 |
Infection (Occuring in ≥3% of Patients) | 43.5 (358) | 23.6 |
Serious Infection | 5.0 (41) | 1.9 |
Nasopharyngitis | 10.3 (85) | 4.1 |
COVID-19 | 8.0 (66) | 3.0 |
Upper Respiratory Tract Infection | 6.8 (56) | 2.7 |
Herpes Zoster | 3.5 (29) | 1.3 |
Sinusitis | 3.4 (28) | 1.3 |
Bronchitis | 3.0 (25) | 1.2 |
Influenza | 3.0 (25) | 1.2 |
Malignancyr | 1.6 (13) | 0.6 |
Data cutoff: January 10, 2022.10
EAIR=exposure-adjusted incidence rate; NR=not reported; OLE=open-label extension; SAE=serious adverse event; TEAE=treatment-emergent adverse event; UC=ulcerative colitis; ULN=upper limit of normal.
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