Type I SMA "new natural history": long-term data in nusinersen-treated patients

Ann Clin Transl Neurol. 2021 Mar;8(3):548-557. doi: 10.1002/acn3.51276. Epub 2021 Feb 6.

Abstract

Objective: The aim of this paper was to report the 2-year follow-up in type I patients treated with Nusinersen and to assess whether possible changes in motor function are related to the subtype, age, or SMN2 copy number.

Methods: Sixty-eight patients, with ages ranging from 0.20 to 15.92 years (mean: 3.96; standard deviation: +3.90) were enrolled in the study. All patients were assessed using the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) and the developmental section of the Hammersmith Infant Neurological Examination (HINE-2) at the time they started treatment and 12 and 24 months after that.

Results: For both CHOP and HINE-2 repeated measures analysis of variance showed a significant difference (P < 0.001) between baseline and 12 months, 12 months and 24 months, and baseline and 24-month scores for the whole group. When age subgroups (<210 days, <2 years, 2-4 years, 5-11 years, 12-18 years) were considered, on the CHOP INTEND the difference was significant between baseline and 24 months in all age subgroups. On the HINE-2, the difference between baseline and 24 months was significant in all the subgroups before the age of 4 years. Age was predictive of changes on both scales (P < 0.05), whereas SMN2 copy number and decimal classification were not.

Interpretation: Our results suggest that some improvement of motor function can be observed even after the first year of treatment. This is more obvious in the infants treated in the first 2 years but some improvement can also be found in older children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Infant
  • Oligonucleotides / pharmacology*
  • Outcome Assessment, Health Care*
  • Severity of Illness Index
  • Spinal Muscular Atrophies of Childhood / drug therapy*
  • Spinal Muscular Atrophies of Childhood / genetics
  • Spinal Muscular Atrophies of Childhood / physiopathology*
  • Survival of Motor Neuron 2 Protein / genetics

Substances

  • Oligonucleotides
  • SMN2 protein, human
  • Survival of Motor Neuron 2 Protein
  • nusinersen

Grants and funding

This work was funded by Fondazione Telethon grant GSP 13002.