Medical Pharmacology: Immunopharmacology (Immunosuppressant/Immunomodulator) Practice Questions

Ozanimod (Zeposia):
1. Classified as they sphingosine-1-phosphate receptor modulator.
2. Effective for the treatment in adults who exhibit who exhibit relapsing forms of multiple sclerosis (USA); In Europe indicated also for treating adults with relapsing-remitting MS (RMS).
3. Both
4. Neither
Ozanimod, as a sphingosine-1-phosphate receptor modulator:
1. Decreases egress of lymphocytes from secondary lymphoid organs, such as lymph nodes, spleen, and tonsils
2. Ozanimod administration would be expected to decrease lymphocyte count in peripheral blood.
3. Both
4. Neither
Ozanimod: clinical use/uses
1. Treatment of relapsing forms of multiple sclerosis (MS) such as clinically isolated syndrome, relapsing-remitting presentations, as well as active secondary progressive disease.
2. Treatment of moderately to severely active cases of ulcerative colitis in adults.
3. Both
4. Neither
Ozanimod as a receptor modulator acts by binding with high affinity to sphingosine-1-phosphate receptors 1 and 5.
1. True
2. False
The probable mechanism by which ozanimod is therapeutically effective in multiple sclerosis and ulcerative of colitis, although not definitively determined, is thought most likely a consequence of reduced lymphocyte migration into the CNS (MS) and into the intestines (ulcerative colitis).
1. True
2. False
The extent of mean lymphocyte reduction in MS and ulcerative colitis patients as result of Zeposia administration is of the order of 45% at three months.
1. True
2. False
The examples/examples of serious side effects associated with ozanimod (Zeposia) administration include/include:
1. Serious infections
2. Progressive multifocal leucoencephalopathy (PML)
3. Both
4. Neither
Initial administration of ozanimod (Zeposia) often induces a reduction in heart rate (bradyarrhythmia). This effect is most likely to occur within the first eight days following administration.
1. True
2. False
Zeposia should not be taken if which one/ones of the following apply
1. The patient is at the heart attack, exhibits unstable angina, stroke/mini stroke or heart failure (during the last six months)
2. The patient has a headache history or exhibits certain arrhythmias not corrected by pacemaker implantation.
3. The patient exhibits significant breathing problems during sleep (e.g. sleep apnea).
4. The patient takes a drug from the category of monoamine oxidase inhibitors (MAO inhibitors). Examples of these agents include selegeline, phenelzine, and linezolid.
5. All of the above represents absolute contraindications
Some possible side effects associated with Zeposia administration:
1. Hepatic abnormalities including jaundice or dark-colored urine
2. Elevated blood pressure
3. Macular edema
4. All of the above

"My Unbiased Breakdown of Zeposia (Ozanimod) for Ulcerative Colitis"

Attribution: Kakodkar S My Unbiased Breakdown Zeposia (Ozanimod) or Ulcerative Colitis (February 27, 2022) (51 min) https://www.youtube.com/watch?v=E2fiCCMfxc8 True North Study: Saanborn W Feagan B D'Haens Wolf D Jovanovic I Hanauer S Ghosh S for the True North Study Group Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis. https://www.nejm.org/doi/full/10.1056/NEJMoa2033617

"My Unbiased Breakdown of Zeposia (Ozanimod) for Ulcerative Colitis"

Attribution:
- Kakodkar S My Unbiased Breakdown Zeposia (Ozanimod) or Ulcerative Colitis (February 27, 2022) (51 min)
  - https://www.youtube.com/watch?v=E2fiCCMfxc8
    - True North Study: Saanborn W Feagan B D'Haens Wolf D Jovanovic I Hanauer S Ghosh S for the True North Study Group Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis. https://www.nejm.org/doi/full/10.1056/NEJMoa2033617