Management of Multiple Sclerosis and Effectiveness of Ozanimod in Relapsing Multiple Sclerosis

Multiple Sclerosis (MS) is termed as an autoimmune disorder characterised by multiple demyelinating lesions in the central nervous system (CNS). Till date, no drug provides the complete cure for MS. All the immunotherapeutic agents and most of the receptor modulators target Relapsing Multiple Sclerosis (RMS). Thus the main challenge until recent times remained to develop a suitable therapy for Secondary progressive MS (SPMS), until the approval of the non-selective sphingosine-1-phosphate (S1P) receptor modulator Fingolimod in 2010 which led to the discovery of many such drugs over the years. The most recent FDA approved drug named Ozanimod is a selective receptor modulator of S1P which targets a receptor subtypes S1PR1 and S1PR5 thereby resulting in decreased lymphocyte migration into CNS. Like fingolimod and siponimod, it induces rapid internalisation and degradation of S1PR1 and produces a decrease in circulating B and T lymphocytes. However, when compared to Fingolimod and Siponimod, Ozanimod has quicker lymphocyte reconstitution, after discontinuation. Apart from regular action, modulation of S1PR with Ozanimod also decreases inflammatory cell infiltration of CNS leading to reduced disease activity in patients with MS. Thus, the use of ozanimod in patients with RMS may provide promising results due to its high efficacy and very low frequency of side effects.