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Ozanimod (Zeposia°) in multiple sclerosis. As ineffective and probably as toxic as fingolimod

FEATURED REVIEW This immunosuppressant has been authorised in the European Union for use in adults with a relapsing-remitting form of multiple sclerosis. Is ozanimod more effective than an interferon beta at reducing the number of relapses and slowing the progression of disability? And what are its adverse effects?
Full review (3 pages) available for download by subscribers.

Prescrire's rating

  •  NOT ACCEPTABLE  According to two randomised trials in about 2700 patients with a relapsing-remitting form of multiple sclerosis, ozanimod appears to prevent one more relapse than interferon beta for every 6 to 9 years of treatment, an estimate based on 2 years' follow-up at most. In these trials, ozanimod was no more effective than interferon beta at slowing the progression of disability. In the short term, fewer patients developed flu-like symptoms, but more developed liver, lung or ocular disorders, and hypertension. Ozanimod also causes many drug interactions. Many unknowns persist, mainly concerning its long-term effects, especially since an immunosuppressant belonging to the same pharmacological class, fingolimod, can provoke cancer and serious hepatic and cardiac disorders. With no evidence that it is more effective or less toxic than fingolimod, ozanimod has an unfavourable harm-benefit balance as of early 2022. 
     

©Prescrire 1 May 2022

Source: "Ozanimod (Zeposia°) in multiple sclerosis. As ineffective and probably as toxic as fingolimod" Prescrire International 2022; 31 (237): 117-119. Subscribers only.

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