ozanimod + cyclosporine

Ozanimod + cyclosporine is a combination of two immunomodulatory drugs. - **Ozanimod** is a selective sphingosine 1-phosphate (S1P) receptor modulator that binds with high affinity to S1P receptor subtypes 1 and 5, leading to internalization of the S1P1 receptor and retention of lymphocytes in lymphoid tissue. This action reduces lymphocyte migration, which decreases immune cell infiltration and inflammation in diseases such as multiple sclerosis and ulcerative colitis[1][2][4][5]. - **Cyclosporine** is a calcineurin inhibitor that suppresses T-cell activation by inhibiting the transcription of interleukin-2, a key cytokine for T-cell proliferation. This combination is not an established or approved fixed-dose product, but may be used in sequential or overlapping therapy, particularly for acute, severe ulcerative colitis refractory to steroids, where cyclosporine may be used for induction, followed by ozanimod for maintenance[1]. The main concern with combined immunosuppressive therapy is increased risk of infection and additive immunosuppression.