Dr Regueiro reviews the results of 2 research projects at Cleveland Clinic on sphingostine 1-phosphate modulators in treatment of inflammatory bowel disease.

Miguel Regueiro, MD, is chair of the Digestive Disease and Surgery Institute at Cleveland Clinic in Cleveland, Ohio.

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TRANSCRIPT:

Miguel Regueiro:
I am Dr. Miguel Rugiero. I'm the Chair of the Digestive Disease and Surgery Institute at Cleveland Clinic in Cleveland, Ohio.
At DDW 2023, Cleveland Clinic had a number of abstracts, oral presentations, and other exciting research that we showed the world. I'd like to highlight two abstracts in which I was involved as the first author, although these were out of Cleveland Clinic as the first author. These were multidisciplinary multi-center sites around the world.

Both of these have to do with Sphingosine-1 phosphate modulator, a new treatment approach for inflammatory bowel disease, or what we refer to as S-1Ps. One was on Ozanimod, and it was looking at an interim analysis over two years of the true north study. But the aspect that we looked at and studied was what happens to patients who stop Ozanimod, and then restart the Ozanimod for ulcerative colitis.

And what we actually found was interesting. Even though patients who came off of Ozanimod, had stopped for whatever reason, were able to successfully restart and recapture clinical remission, endoscopic remission, and histologic improvement.
So, the take home message from that study was that actually, if a patient does need to stop, something happens, insurance, some delay, they are able to restart the medication successfully. And Ozanimod works, again, at recapturing that response in remission and ulcerative colitis.

The second abstract I'd like to highlight is another S-1P modulator called Etrasimod. Etrasimod is not yet FDA approved in the United States, however, it should be approved probably within the next few months for ulcerative colitis. The Etrasimod study that we looked at was what happens in terms of overall infection rates as a possible adverse event from an Etrasimod. What was very comforting to see in the study is that Etrasimod compared to placebo, did not have an increased infection rate. So, there was no signal for increased infections, with Etrasimod, this S-1P modulator.

The other interesting part was, if anything, we saw higher rates of infection in placebo and higher rates of herpes zoster. Not to say that placebo was bad or caused a problem, but it's just interesting. And, if anything, we wonder if Etrasimod puts the patient in remission, they're overall healthier, maybe they have less infection.

So, stay tuned as far as whether that's the case, but there was no increased signal of infection with Etrasimod, and we look forward to Etrasimod coming to the FDA, and coming to the United States market for the approval and use of ulcerative colitis.

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