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Nusinersen versus Sham Control in Infantile-Onset Spinal Muscular Atrophy

Autosomal recessive neuromuscular disorder, spinal muscular atrophy is caused by homozygous deletion of SMN1 gene. Intrathecal nusinersen is an experimental drug, that modifies pre-mRNA splicing of  SMN2 gene(that is a paralogous gene to SMN1) to promote increased production of SMN protein.

A 13-month, international, randomized, multicenter, sham-controlled, phase 3 trial that assessed clinical efficacy and safety of nusiresen showed that infants in nusinersen group showed a significantly better motor-milestone response (head control, rolling, sitting independently, standing, necessity of feeding and respiratory support) than infants in control group, besides, infants in that group showed less adverse events and decreased mortality rate. Data suggest that early initiation of treatment may maximize its efficacy. But none of the infants in nusinersen group achieved normal motor development. Those findings indicate that nusinersen is not a cure in patients with spinal muscular atrophy.

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