AVXS-101 (Onasemnogene Abeparvovec) for SMA 1: Comparative Study with a Prospective Natural History Cohort

被引:139
作者
Al-Zaidy, Samiah A. [1 ,2 ]
Kolb, Stephen J. [3 ,4 ]
Lowes, Linda [1 ,2 ]
Alfano, Lindsay N. [1 ,2 ]
Shell, Richard [2 ]
Church, Kathleen R. [1 ]
Nagendran, Sukumar [5 ]
Sproule, Douglas M. [5 ]
Feltner, Douglas E. [5 ]
Wells, Courtney [5 ]
Ogrinc, Francis [5 ]
Menier, Melissa [5 ]
L'Italien, James [5 ]
Arnold, W. David [3 ]
Kissel, John T. [2 ]
Kaspar, Brian K. [5 ]
Mendell, Jerry R. [1 ,2 ,3 ]
机构
[1] Nationwide Childrens Hosp, Ctr Gene Therapy Res Inst, Columbus, OH 43205 USA
[2] Ohio State Univ, Dept Pediat, Wexner Med Ctr, Columbus, OH 43210 USA
[3] Ohio State Univ, Dept Neurol, Wexner Med Ctr, Columbus, OH 43210 USA
[4] Ohio State Univ, Dept Biol Chem & Pharmacol, Wexner Med Ctr, Columbus, OH 43210 USA
[5] AveXis Inc, Bannockburn, IL USA
关键词
Gene therapy; spinal muscular atrophy; natural history; neuromuscular diseases;
D O I
10.3233/JND-190403
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Background: Spinal muscular atrophy type 1 (SMA1) is the leading genetic cause of infant mortality for which therapies, including AVXS-101 (onasemnogene abeparvovec, Zolgensma (R)) gene replacement therapy, are emerging. Objective: This study evaluated the effectiveness of AVXS-101 in infants with spinal muscular atrophy type 1 (SMA1) compared with a prospective natural history cohort and a cohort of healthy infants. Methods: Twelve SMA1 infants received the proposed therapeutic dose of AVXS-101 (NCT02122952). Where possible, the following outcomes were compared with a natural history cohort of SMA1 infants (n = 16) and healthy infants (n = 27) enrolled in the NeuroNEXT (NN101) study (NCT01736553): event-free survival, CHOP-INTEND scores, motor milestone achievements, compound muscle action potential (CMAP), and adverse events. Results: Baseline characteristics of SMA1 infants in the AVXS-101 and NN101 studies were similar in age and genetic profile. The proportion of AVXS-101-treated infants who survived by 24 months of follow-up was higher compared with the NN101 study (100% vs 38%, respectively). The average baseline CHOP-INTEND score for NN101 SMA1 infants was 20.3, worsening to 5.3 by age 24 months; the average baseline score in AVXS-101-treated infants was 28.2, improving to 56.5 by age 24 months. Infants receiving AVXS-101 achieved motor milestones, such as sitting unassisted and walking. Improvements in CMAP peak area were observed in AVXS-101-treated infants at 6 and 24 months (means of 1.1 and 3.2 mV/s, respectively). Conclusions: In this study, AVXS-101 increased the probability of survival, rapidly improved motor function, and enabled motor milestone achievement in SMA1 infants.
引用
收藏
页码:307 / 317
页数:11
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