Nusinersen: Single-Centre Real-Life Experience in Type 1 Spinal Muscular Atrophy

Date of submission: 31-10-2020 | Date of acceptance: 04-03-2021 | Published: 03-10-2021

Abstract

Introduction: Nusinersen, an antisense oligonucleotide designed to treat spinal muscular atrophy, led to substantial motor milestone achievements in clinical trials. The aim of this study was to report the clinical outcome of children diagnosed with spinal muscular atrophy type 1 treated with nusinersen in a tertiary centre.

Methods: Retrospective study of type 1 spinal muscular atrophy patients treated with nusinersen for more than six months. Clinical, genetic, ventilation and feeding parameters were obtained. Motor assessment included Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders.

Results: Four patients were eligible for this evaluation, with a current mean age of 33.8 months (range 25-42 months), three with two copies of SMN2 gene and one with three copies. The mean time from first symptoms to diagnosis confirmation was 3 months (range 0.3-10.0 months) and from diagnosis confirmation to the beginning of treatment 1.2 months (range 0.5-1.7 months). All patients improved at least eleven points in motor score (mean change: 18.5 points). Three patients achieved stable sitting and one sits with support. They are all free from continuous ventilation. The mean number of hospital admissions due to respiratory exacerbations per year variated from 0 to 4.2. Gastrostomy was performed in two patients and two have total oral feeding.

Discussion: We observed an improvement in motor function and ventilatory support in spinal muscular atrophy type 1 patients treated with nusinersen. Despite our small sample, our findings contribute to the increasing evidence that early diagnosis and treatment is paramount for these patients.