Etrasimod is a novel oral selective sphingosine-1-phosphate (S1P) receptor modulator.
How to Use Etrasimod
Administration Time
It is recommended to take Etrasimod at a fixed time every day, either with food or on an empty stomach.
If a dose is missed, take the missed dose as soon as you remember. However, if it is almost time for the next scheduled dose, skip the missed dose and continue with the next dose as planned. Do not take a double dose to make up for the missed one.
Treatment Course Arrangement
For the treatment of ulcerative colitis, Etrasimod usually requires continuous administration to maintain efficacy. The duration of the treatment course should be determined by the doctor based on the patient’s response and disease activity.
For multiple sclerosis, long-term maintenance treatment is generally required.
Dosage Adjustment of Etrasimod
Adjustment Based on Safety
Consider dose reduction or temporary discontinuation in the following situations:
Sustained decrease in heart rate (< 50 beats per minute).
Abnormal liver function (ALT/AST > 3 times the upper limit of normal [ULN]).
Sustained lymphocyte count < 0.2 × 10⁹/L.
During a severe infection.
Switching Treatment Regimens
Switching from fingolimod: Wait for at least 24 hours after discontinuing fingolimod before starting Etrasimod.
Switching from siponimod: No washout period is required.
Medication for Special Populations of Etrasimod
Elderly Patients
For patients aged 65 years and older, no adjustment to the initial dose is needed. However, since elderly patients are more prone to bradycardia and other adverse reactions, enhanced monitoring is required—especially 6-hour electrocardiographic (ECG) monitoring during the initial phase of treatment.
Patients with Hepatic Impairment
Mild hepatic impairment (Child-Pugh Class A): No dose adjustment is required.
Moderate hepatic impairment (Child-Pugh Class B): The recommended dose should not exceed 1 mg per day.
Severe hepatic impairment (Child-Pugh Class C): Use is contraindicated.
Patients with Renal Impairment
Mild to moderate renal impairment (eGFR 30–89 mL/min/1.73m²): No dose adjustment is required.
Severe renal impairment (eGFR < 30 mL/min/1.73m²): Limited data are available for patients with this condition, so Etrasimod should be used with caution.
Pregnant and Lactating Women
Etrasimod may cause harm to the fetus. Women of childbearing potential should use effective contraceptive measures during treatment and for at least 3 months after discontinuing the drug.
Use during lactation should be avoided. If treatment is necessary, breastfeeding should be discontinued.
Vaccination
Before starting Etrasimod, ensure that the patient has completed all necessary vaccinations—especially the herpes zoster vaccine.
Live vaccines should be avoided during Etrasimod treatment and for 3 months after discontinuing the drug.
