Antisense Oligonucleotide for Spinal Muscular Atrophy

Study Overview
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Brief Summary
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This is a longitudinal, multiple-center, observational study of patients genetically confirmed chromosome 5q SMA to monitor the efficacy, safety, tolerability of SPINRAZA® (nusinersen) for up to 24 months.

Detailed Description
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SPINRAZA® (nusinersen) is an antisense oligonucleotide (ASO) designed to treat SMA caused by mutations in chromosome 5q that lead to SMN protein deficiency. Nusinersen, approved by the FDA for treatment of SMA in 2016, was approved by the Chinese National Medical Products Administration in 2019. This is a prospective, longitudinal, multi-center, observational study designed to evaluate the efficacy, safety, tolerability and of nusinersen in patients genetically confirmed chromosome 5q SMA in China. Subjects with SMA I/II/III who are planning to initiate treatment with nusinersen will be enrolled in this study. All patients will be treated by their physicians according to standard clinical practice. SPINRAZA® (nusinersen) is administered as an intrathecal injection. A total of 5ml of cerebrospinal fluid (CSF) will be removed prior to administration of SPINRAZA® (nusinersen), which will be collected by the study. Neurofilament light chain (NfL) in CSF and blood will be assessed for the efficacy of nusinersen, as well as motor and pulmonary function. There will be a total of nine visits. All the patients with 5q SMA receiving nusinersen will be visited face to face at baseline, day 14, day 28 and day 63 after treatment initiation, and then 4-month intervals through month 24/22.

Official Title
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Antisense Oligonucleotide Therapy in Spinal Muscular Atrophy: An Observational Study in China

Conditions
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Spinal Muscular Atrophy

Intervention / Treatment
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* Drug: Nusinersen


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients genetically confirmed 5q SMA including types I, II and III, who are planning to initiate treatment with SPINRAZA® (nusinersen) as part of their clinical care plan. Non-5q SMA patients undergoing clinical standard lumbar puncture Non-SMA subjects including Asymptomatic carriers of SMA, relatives of SMA patients and carriers, and patients undergoing clinical standard lumbar puncture Participants or Parent(s)/legal guardian(s) willing and able to complete the informed consent process Exclusion Criteria: Contraindication for lumbar puncture Inability to access intrathecal space for nusinersen injection

Ages Eligible for Study
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Minimum Age: 1 Week
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 5q SMA type I<br> | Drug: Nusinersen<br>* SPINRAZA® (nusinersen) prescribed as part of standard of care<br>|
| 5q SMA type II<br> | Drug: Nusinersen<br>* SPINRAZA® (nusinersen) prescribed as part of standard of care<br>|
| 5q SMA type III<br> | Drug: Nusinersen<br>* SPINRAZA® (nusinersen) prescribed as part of standard of care<br>|
| Non-5q SMA<br> | |
| Non-SMA subjects<br>Including asymptomatic carriers of SMA, relatives of SMA patients and carriers, and patients undergoing clinical standard lumbar puncture | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in CSF Neurofilament Light Chain levels since baseline | Measured by Single-molecule Array | up to 24months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in serum Neurofilament Light Chain levels since baseline | Measured by Single-molecule Array | up to 24months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Spinal Muscular Atrophy, Antisense oligonucleotide, Neurofilament light chain