Zeposia, whose generic name is ozanimod, is a medication primarily used to treat relapsing forms of multiple sclerosis (MS) and ulcerative colitis. It works by modulating the immune system, specifically by targeting certain receptors on immune cells to reduce their movement into the central nervous system or inflamed gut tissue. This immune modulation helps decrease inflammation and disease activity. However, because Zeposia affects the immune system, it can also increase the risk of infections.
The way Zeposia increases infection risk is tied to its mechanism of action. It selectively binds to sphingosine-1-phosphate (S1P) receptors on lymphocytes, a type of white blood cell involved in immune responses. By binding to these receptors, Zeposia traps lymphocytes in lymph nodes, preventing them from circulating freely in the bloodstream and reaching sites of inflammation. While this reduces harmful immune attacks on the nervous system or gut, it also lowers the body’s ability to fight off infections, especially those caused by viruses, bacteria, and fungi.
Clinical data and patient reports have shown that people taking Zeposia may experience a higher incidence of infections compared to those not on the drug. Common infections include upper respiratory tract infections such as colds or throat infections, and urinary tract infections. More serious infections, although less frequent, have also been reported. These can include shingles (herpes zoster), pneumonia, meningitis, and in rare cases, a severe brain infection called progressive multifocal leukoencephalopathy (PML). PML is caused by the reactivation of a dormant virus in the brain and is a known risk with several immunosuppressive therapies.
Because of these risks, patients on Zeposia are closely monitored by their healthcare providers. Before starting treatment, doctors typically screen for infections like tuberculosis and check vaccination status to reduce the risk of preventable infections. During treatment, patients are advised to promptly report symptoms such as fever, chills, persistent cough, or unusual fatigue, which could indicate an infection. If a serious infection develops, Zeposia treatment may need to be paused or stopped to allow the immune system to recover.
In addition to infections, Zeposia can cause other side effects related to immune suppression, such as liver enzyme elevations and allergic reactions. Allergic reactions can range from mild rashes to severe swelling or breathing difficulties, which require immediate medical attention. The drug can also cause a temporary slowing of the heart rate when treatment begins, so initial dosing is carefully managed.
It’s important to note that while Zeposia increases infection risk, this risk must be balanced against the benefits of controlling MS or ulcerative colitis symptoms, which themselves can be debilitating or life-threatening. The immune system modulation provided by Zeposia can significantly reduce disease relapses and progression, improving quality of life for many patients.
Patients should not stop taking Zeposia without consulting their healthcare provider, as abrupt discontinuation can lead to a severe worsening of MS symptoms. Instead, any concerns about infections or side effects should be discussed with a medical professional who can adjust treatment plans accordingly.
In summary, Zeposia does increase the risk of infections due to its immune-modulating effects. This risk includes common infections like colds and UTIs, as well as rare but serious infections such as shingles and PML. Careful monitoring, preventive measures, and open communication with healthcare providers are essential to safely managing these risks while benefiting from the medication’s therapeutic effects.
