Advanced therapy medicinal products in Saudi Arabia: Regulation and development

Advanced therapeutic medicinal products (ATMPs) such as gene, somatic cell, and tissue-engineered therapies have transformed modern healthcare by treating previously unmanageable genetic, oncologic, and degenerative diseases. Although regulatory and developmental frameworks for ATMPs are established in the United States, Europe, and China, limited data exist on their implementation in emerging markets such as Saudi Arabia. This review provides the first comprehensive analysis of ATMP regulation and development in Saudi Arabia while offering novel insights into the nation's evolving clinical trial landscape, regulatory infrastructure, and biomanufacturing capabilities. We conducted a narrative review of the Saudi Food and Drug Authority (SFDA) guidelines, peer-reviewed literature, and clinical trial registrations from 2010 to 2025. As of 2025, the SFDA has approved eight ATMPs, including chimeric antigen receptor T-cell therapy (CAR-T) therapies, adeno-associated virus (AAV) based vectors, and clustered regularly interspaced short palindromic repeats (CRISPR) based therapies, reflecting growing regulatory maturity and international alignment. Clinical trial activity continues to expand, with a concentration in oncology, hematology, and rare genetic diseases. National research institutions such as the King Faisal Specialist Hospital and Research Centre (KFSHRC) and King Abdullah International Medical Research Center (KAIMARC) have pioneered advances in CAR-T manufacturing, while biobanking initiatives are driving translational research. Despite ongoing challenges in workforce capacity, good manufacturing practice (GMP) infrastructure, and reimbursement mechanisms, Saudi Arabia is positioned to become a regional leader in advanced therapies through continued regulatory innovation, local manufacturing, and international collaboration.