New Medication Class for Ulcerative Colitis
Ulcerative colitis is an inflammatory bowel disease (IBD) that consists of fine ulcerations in the inner mucosal lining of the large intestine (colon). Symptoms include rectal bleeding, diarrhea accompanied by abdominal pain, constipation, and extra-intestinal manifestations such as fever and inflammation of the eyes or joints.
While there is no cure, there are many ways to manage this disease, such as medications, surgery, and accompanying dietary and lifestyle modifications. However, for some people, the current approaches might not effectively control their symptoms. Individuals living with ulcerative colitis have diverse medical needs, so some might fail on these therapies, experience adverse side effects, or have difficulties administering medications (e.g., infusion, injection, suppository). In our IBD Unmet Needs global survey,1 33% of respondents reported that their medications did not adequately control their symptoms. Many expressed concerns over their medication’s side effects and cost.
Recently, scientists have developed a new medication class that could provide additional options to address this unmet need. Sphingosine-1-phosphate (S1P) receptor modulators are small, signalling molecules that selectively activate five different protein receptors involved in physiological processes that are essential for the immune, cardiovascular, and nervous systems.2 They help decrease intestinal inflammation and may overcome the limitation of biologics, another treatment option for ulcerative colitis. Biologics are proteins that selectively block molecules involved in the inflammatory process and, over time, our bodies might develop antibodies to these proteins, which can diminish the drug’s effectiveness and lead to treatment failure.
Clinical trials around the world have been studying three S1P modulators for the treatment of ulcerative colitis, Crohn’s disease, eosinophilic esophagitis, and multiple sclerosis.2 These medications are ozanimod, etrasimod, and amiselimod. All are in oral capsule form and target different protein receptors.
In April 2022, Health Canada approved ozanimod (Zeposia®) for adults younger than 65 with moderately to severely active ulcerative colitis when other medicines do not work or cannot be used. It can be used before or after taking biologics.3 Health Canada also approved Zeposia® for multiple sclerosis.
Zeposia® helps reduce intestinal inflammation by attaching to specific white blood cells and preventing them from leaving the lymph nodes.3 This decreases the number of white blood cells circulating in the body and reaching the lining of the intestine.
You must consume this drug whole, with or without food, and you can store it at room temperature, between 15°C and 25°C. This medication remains in your blood for up to three months so you may continue to experience effects after you take your last prescribed dose.
This medication is not for those who are hypersensitive or allergic to any ingredient in the drug, are at an increased risk of infection, or currently have an infection (e.g., hepatitis, tuberculosis). Please consult your gastroenterologist for more information about this medication.