A recent study presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) forum revealed that patients with relapsing multiple sclerosis (RMS) who were continuously treated with ozanimod (Zeposia) for 7 to 8 years exhibited stable or improved clinical and radiologic measures of disease activity. Regardless of the age category, the adjusted annualized relapse rate remained below 0.2, indicating the effectiveness of ozanimod in managing RMS. Jeffrey Cohen, MD, of the Cleveland Clinic in Ohio, shared that patients across different age groups experienced lower rates of relapse when treated with ozanimod, compared to those who were initially on interferon beta-1a before switching to ozanimod.
The study included 2,257 RMS patients from the SUNBEAM and RADIANCE trials who participated in the open-label DAYBREAK extension study. Patients treated continuously with 0.92 mg ozanimod from the start of the phase III trials showed promising results across different age brackets, with a noticeable decline in relapse rates and other disease activity measures. It was observed that even patients who transitioned from interferon to ozanimod during the open-label extension saw similar outcomes to those who had been on ozanimod throughout the duration of the trials.
One interesting finding highlighted in the study was the relationship between age and the number of gadolinium-enhancing lesions, which averaged 0.6 per scan during the open-label extension. Additionally, the number of new or enlarging T2 lesions per scan decreased as patients aged, suggesting a potential decline in immune activity over time. Cohen emphasized that this observation aligns with previous knowledge of disease progression in relapsing multiple sclerosis and raises questions about the impact of aging on immune function.
The long-term efficacy and safety of ozanimod in RMS patients, particularly in older individuals, were significant aspects of the study. While concerns about infection risks in older patients receiving immune-modulating agents exist, the results from the DAYBREAK extension study provided reassurance to clinicians. The data indicated that older patients did not experience an increased risk of infections during extended treatment with ozanimod, offering confidence in the medication’s safety profile.
In a companion study presented alongside the main findings, Cohen and colleagues reported that treatment with 0.92 mg ozanimod demonstrated prolonged disease control exceeding previously reported durations. Patients remained on ozanimod for an average of 60.9 months, with some individuals continuing treatment for up to 117.2 months. The low annualized relapse rate, minimal new or enlarging T2 lesions, and low numbers of gadolinium-enhancing lesions on brain MRI highlighted the sustained efficacy of ozanimod over an extended period. Safety findings were consistent with previous trials, emphasizing the favorable tolerability of ozanimod as a treatment option for RMS.
Overall, the data presented in these studies underscore the importance of continuous treatment with ozanimod in managing RMS and offer insights into the long-term effects of the medication across different age groups. The findings provide valuable information for clinicians and patients alike, supporting the use of newer agents like ozanimod in the management of relapsing multiple sclerosis.