Jordan Axelrad, MD, on S1P Receptor Modulators in IBD

Dr Axelrad discusses his presentation at the AIBD regional meeting on the value and positioning of sphingosine 1-phosphate receptor modulators for the treatment of inflammatory bowel disease.

Jordan Axelrad, MD, MPH, is director of Clinical and Translational Research at the Inflammatory Bowel Disease Center at NYU Langone Health in New York, New York.

TRANSCRIPT:

I'm Jordan Axelrad from NYU Langone Health, and I'm here at AIBD Regionals, and I just finished presenting on S1P receptor modulators in ulcerative colitis. I think that the addition of S1P receptor modulators has been a critical, important addition to our therapeutic arsenal in ulcerative colitis. We've learned quite a bit over the past couple of years since the introduction of ozanimod and now recently etrasimod for moderate to severe ulcerative colitis and how to utilize and target these therapies for specific patients.

These therapies work quite well for patients who exhibit moderate disease activity as a first-line therapy for those who are naive to other advanced therapies. And it works particularly fast. So there's also data from both ozanimod and etrasimod that symptomatic relief actually happens quite quickly, typically by week 2.

And for patients who achieve response during induction, patients often maintain that response over time. And there’s also been recent data presented here on ozanimod up to over 90 weeks of follow-up that patients who achieved remission during the maintenance studies maintained that out to more than 90 weeks. So ozanimod and etrasimod, both effective therapies for moderate to severe ulcerative colitis, really best positioned as a first-line therapy for advanced treatment-naïve patients.

There are some unique characteristics about the S1P receptor modulators in that they require a little more work before we can prescribe therapy, and it’s a little different from what we’re used to with our biologic and JAK inhibitor therapies. Patients require an EKG to rule out induction abnormalities since there are S1P targets on the heart. And for patients who will be exposed to etrasimod, an eye exam to look specifically for macular edema and a skin exam are required around the time of therapy initiation.

Although there are these sort of regulatory requirements before initiating therapy, these drugs are both extremely safe and very well tolerated and this is nice finally having a first-line oral treatment option for patients with moderate ulcerative colitis I think is a really great addition to our treatment arsenal.