Table 5.

Recommended Ozanimod pre-treatment assessment

Baseline Assessment	Test	Advice
Cardiac Evaluation&	ECG to exclude baseline bradyarrythmias or conduction blocks, blood pressure, check drug history for medications that may slow heart rate or AV conduction	Cardiac contraindications: MMI, unstable angina, class III or IV heart failure, type 2 second degree or type 3 degree AV block, sick sinus syndrome, significant QTc prolongation
Complete Blood Count	Including lymphocyte count	Patients with counts <0.2 × 109/L were excluded from trial programs, a mean 50% reduction in total lymphocyte count is expected
Liver Function Tests	Transaminases and bilirubin level	5% develop transaminitis > 3x ULN
Ophthalmic Assessment	Fundoscopy	Patients with a history of diabetes, uveitis or macular edema
Virology and TB	Hep B, VZV serology and TB IGRA	Consider VZV vaccination if VZV IgG negative (live vaccines require administration 3 months prior to initiation). Herpes zoster is the most common opportunistic infection
Other contraindications	Patient history	TIA or stroke < 6 months, severe untreated sleep apnea
Review current or prior medications	Patient history	Anti-neoplastic, immunosuppressive, or immune-modulating therapies may lead to unintended additive immunosuppression. Monoaminooxidase inhibitors are contraindicated
Dose titration at start	Titrate once daily dose to maintenance dose at one week: 0.25mg days 1–4, 0.5mg days 5–7, then 1mg QD

^&Request cardiologist consultation in patients with a preexisting cardiac condition.AV, atrioventricular; ECG, electrocardiogram; VZV, varicella-zoster virus; MI, myocardial infarction; QTc, QT Interval; ULN, upper limit of norm; TB, tuberculosis; IGRA, interferon-gamma release assays; Hep B, hepatitis B virus; TIA, transient ischemic attack; QD, every day.