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Nusinersen for SMA: expanded access programme.

Michelle A Farrar1,2, Hooi Ling Teoh1,2, Kate A Carey1,2

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This summary is machine-generated.

The first Australian experiences with nusinersen expanded access for spinal muscular atrophy (SMA) type 1 revealed challenges in early diagnosis and evolving clinical care for this motor neuron disorder.

Keywords:
nusinersenspinal muscular atrophy

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Area of Science:

  • Neurology
  • Genetics
  • Pediatrics

Background:

  • Spinal muscular atrophy (SMA) is a severe motor neuron disease characterized by progressive muscle weakness and respiratory failure.
  • Nusinersen represents the first disease-modifying therapy for SMA, offering a new treatment avenue.

Purpose of the Study:

  • To report the initial Australian experiences with an expanded access program (EAP) for nusinersen in infantile-onset SMA type 1.
  • To assess the feasibility and outcomes of providing preapproval access to nusinersen.

Main Methods:

  • An Australian multicenter, open-label EAP for nusinersen was conducted from November 2016 to September 2017.
  • Patients with infantile-onset SMA type 1 received standard care and intrathecal nusinersen.
  • Clinical, genetic, treatment, and functional motor outcomes were evaluated.

Main Results:

  • Sixteen of 20 eligible SMA type 1 patients received nusinersen treatment.
  • Median time to diagnosis was 5.0 months, correlating with age of onset.
  • Management evolved to include proactive nutritional and respiratory support, with increased decision-making complexity.

Conclusions:

  • The nusinersen EAP highlighted challenges in early SMA diagnosis and care evolution.
  • Resource implications and ethical considerations arose during treatment implementation.
  • These findings are relevant to introducing novel therapeutics in neurological disorders.