Ozanimod — an investigational oral therapy up for approval to treat relapsing multiple sclerosis (MS) — lowers the number of white blood cells circulating in the blood, supporting its ability to ease inflammation in the brain and spinal cord.
But this treatment also does not affect all white blood cell types equally, suggesting it may reduce damaging inflammatory responses while preserving some essential immune defenses.
The findings were presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2020, in Florida (Feb. 27–29) by Sarah Harris of Celgene, a subsidiary of Bristol-Myers Squibb. The poster is titled “Effect Of Ozanimod On Circulating Leukocyte Subtypes In Patients With Relapsing Multiple Sclerosis: Results From A Phase 1 Study.”
Ozanimod is an oral small molecule, a sphingosine-1 phosphate receptor (S1PR) modulator, under review for approval in the U.S. and Europe. A U.S. Food and Drug Administration decision is expected by March 25, and one by European Medicines Agency around mid-year.
According to Celgene — the treatment’s developer, now owned by Bristol-Myers Squibb — ozanimod is expected to have a better safety profile and fewer side effects, based on its high selectivity for S1PR types 1 and 5, than other S1P receptor modulators.
Type 1 of these receptors is found on the surface of lymphocytes (immune cells such as T- and B-cells), and is required for these cells to exit lymph nodes and enter the bloodstream.
While ozanimod’s mechanism of action in MS is not fully known, it may involve keeping lymphocytes from reaching the brain and spinal cord (the central nervous system, CNS). By specifically blocking S1P receptor types 1 and 5, the agent would act to hold lymphocytes in lymph nodes, preventing them from entering the CNS. This should lower inflammation, and limit self-directed attacks against myelin (the protective coating on nerve cells whose damage and loss is an MS hallmark).
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