Real-world experience of ozanimod in adults with multiple sclerosis

Ozanimod is a second-generation sphingosine 1-phosphate receptor (S1PR) modulator approved for treatment of relapsing multiple sclerosis (MS). Data are lacking for ozanimod use in real-world clinical practice. This study aims to determine characteristics of people with MS (pwMS) prescribed ozanimod as well as ozanimod persistence, tolerability, safety, and effectiveness over one year. Data were retrospectively collected for adults with MS or clinically isolated syndrome who received ozanimod at two tertiary MS centers. We identified 206 pwMS for inclusion. Many (n = 146, 71%) had prior disease-modifying therapy (DMT) experience. The most common reasons for switching to ozanimod were cost (n = 48, 33%) and prior DMT intolerance (n = 29, 20%). Most individuals (n = 149, 72%) remained on ozanimod at last data collection. The most frequent reason for discontinuation was side effects (n = 21, 37% of discontinuers, 10.2% of total cohort). Few pwMS reported tolerability concerns (7.5% at 12 months). When comparing pre-ozanimod baseline to 12-month data, the annualized relapse rate was reduced by 56% (p = 0.034), and fewer pwMS had new/enlarging brain MRI T2 lesions (6.6% versus 40%, p < 0.001) and gadolinium-enhancing lesions (3.9% versus 27%, p = 0.027). Ozanimod was well-tolerated with good treatment persistence, a favorable safety profile, and reductions in clinical and radiographic disease.