Zeposia (Ozanimod) and Risk of Urinary Tract Infections
Yes, Zeposia (ozanimod) can increase the risk of urinary tract infections (UTIs). According to the FDA drug label, Zeposia increases the susceptibility to infections, specifically mentioning urinary tract infections among the increased risks 1.
Mechanism of Increased UTI Risk
- Zeposia causes a mean reduction in peripheral blood lymphocyte count to approximately 45% of baseline values due to reversible sequestration of lymphocytes in lymphoid tissues 1
- This reduction in lymphocytes may increase susceptibility to various infections, including UTIs 1
- The immunomodulatory effects of Zeposia continue for up to 3 months after the last dose, potentially prolonging infection risk 1
Evidence from Clinical Trials
- In multiple sclerosis (MS) clinical trials, Zeposia increased the risk of viral upper respiratory tract infections, urinary tract infections, and herpes infections compared to control groups 1
- The FDA label specifically warns patients to call their healthcare provider if they experience "painful and frequent urination (signs of a urinary tract infection)" 1
Risk Factors for UTIs to Consider
- Patients with underlying structural or medical problems are at higher risk for complicated UTIs 2
- Risk factors include anatomical abnormalities, indwelling catheters, urinary tract obstruction, voiding dysfunction, diabetes, and immunosuppression 2
- Postmenopausal women are at increased risk for recurrent UTI in the presence of urinary incontinence, cystocele, or high postvoid residuals of urine 2
Management Recommendations
- Monitor patients on Zeposia for signs and symptoms of UTI, including dysuria, frequent urination, and suprapubic pain 1
- Obtain a complete blood count (CBC) including lymphocyte count before initiating Zeposia 1
- Consider interruption of treatment with Zeposia if a patient develops a serious infection 1
- Because elimination of Zeposia after discontinuation may take up to 3 months, continue monitoring for infections throughout this period 1
Prevention Strategies for Patients on Zeposia
- Ensure adequate hydration to promote more frequent urination 2
- Encourage urge-initiated voiding and post-coital voiding 2
- For postmenopausal women with risk factors such as atrophic vaginitis, consider topical vaginal estrogens as appropriate 2
When to Seek Medical Attention
- Patients should contact their healthcare provider if they experience painful and frequent urination 1
- Prompt treatment of UTIs is essential to prevent complications, especially in immunocompromised patients 2
- Consider antimicrobial therapy based on local resistance patterns and specific host factors 2
Important Considerations
- The risk of UTIs with Zeposia should be weighed against its therapeutic benefits for the specific condition being treated 1
- Patients with a history of recurrent UTIs should be monitored more closely when starting Zeposia 2
- Patients with diabetes may need particularly close monitoring as they are already at increased risk for UTIs 2