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Life-Saving Treatments for Spinal Muscular Atrophy: Global Access and Availability
Victor D Armengol1, Basil T Darras1, Ahmad A Abulaban1
1Department of Neurology (VDA, BR), Yale University School of Medicine, New Haven, CT; Department of Neurology (BTD), Boston Children's Hospital, MA; Department of Medicine (AAA), King Saud Bin Abdulaziz University for Health Sciences; Neuromuscular Integrated Practice Unit (AA), Neuroscience Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Department of Pediatrics (NB), University of Zagreb Medical School, Croatia; Genetics and Genomic Medicine Division (TB-O), Sidra Medicine and Hamad Medical Corporation, Doha, Qatar; Department of Pediatrics (GB), Klinik Favoriten, Vienna, Austria; Department of Pediatrics (CC), Clínica Meds, Santiago, Chile; Department of Medical Genetics and Pediatrics (Y-HC), National Taiwan University Hospital, Taipei; Department of Neurology (MAF), Sydney Children's Hospital Network, New South Wales, Australia; Department of Paediatrics and Child Health (GK), College of Health Sciences, University of Zimbabwe, Harare; Department of Neurology (SK), Bombay Hospital, India; Department of Pediatrics (JM), University of Calgary Cumming School of Medicine, Alberta, Canada; John Walton Muscular Dystrophy Research Centre (CM-B), Newcastle University, Newcastle Upon Tyne, United Kingdom; Department of Child (DO), Adolescent, and Developmental Neurology, Children's Hospital, University Medical Centre Ljubljana, Slovenia; Department of Medical Genetics (GP), University of Calgary Cumming School of Medicine, Alberta, Canada; Neurometabolic Unit (FBP), University of Sao Paulo, Brazil; Department of Pediatrics (IPC), Hospital Universitari i Politècnic La Fe, Valencia, Spain; Child Neurology and ICU Department (SQ-R), Raymond Poincaré University Hospital (UVSQ), Garche, France; Institute of Medical Genetics (KS), Tokyo Women's Medical University, Japan; Department of Neurology (J-HS), Pusan National University Yangsan Hospital, South Korea; Neuromuscular Unit (JFV-C), Hospital Universitario y Politécnico la Fe, Valencia, Spain; Friedrich-Baur-Institute (MCW), Department of Neurology, Ludwig-Maximilians-University of Munich, Germany; Department of Paediatrics (JW), University of Colombo, Sri Lanka; Department of Pediatrics (HX), Peking University First Hospital, China; and Department of Neurology (RCG), University of Rochester Medical Center, NY.
New treatments for spinal muscular atrophy (SMA) improve patient outcomes, but global access is unequal. Newborn screening is crucial for early diagnosis and equitable care worldwide.
Area of Science:
- Neurology
- Genetics
- Public Health
Background:
- Spinal muscular atrophy (SMA) is a progressive neurodegenerative disease.
- Recent advancements include gene replacement and splicing modification therapies.
- These treatments significantly improve survival and quality of life for SMA patients.
Purpose of the Study:
- To compare the global availability and implementation of SMA treatments.
- To identify disparities in access to care and treatment barriers.
Main Methods:
- Qualitative study surveying healthcare providers from 21 countries.
- Assessed newborn screening, drug availability, and treatment barriers.
Main Results:
- Nusinersen was the most available SMA therapy globally.
- Genetic testing is widely available, but newborn screening is not.
- High treatment costs present a major barrier to care in many regions.
Conclusions:
- Significant global inequalities exist in managing SMA.
- Expanding newborn screening is vital for improving SMA patient access to care.
- Novel strategies are needed to address disparities in clinical care for genetic diseases.
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