Wurster C D, Günther R
Klinik für Neurologie, Rehabilitations- und Universitätskliniken Ulm, Oberer Eselsberg 45, 89081, Ulm, Deutschland.
Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Deutsches Zentrum für neurodegenerative Erkrankungen (DZNE) Dresden, 01307, Dresden, Deutschland.
Nervenarzt. 2020 Apr;91(4):294-302. doi: 10.1007/s00115-020-00871-7.
5‑q-associated spinal muscular atrophy (SMA) has so far been a causally untreatable disease, which leads to severe, progressive physical restrictions due to the loss of spinal motor neurons. However, the monogenetic cause of the relatively short coding "survival motor neuron" (SMN) 1 gene sequence and the presence of almost identical gene copies, the SMN2 genes, offer favorable conditions for the development of new therapeutic approaches. While previously only supportive and palliative therapies could be used, new disease-modifying drugs are now available for the first time. Nusinersen, an antisense oligonucleotide (ASO), is the first drug that has received approval in Germany to treat SMA. Further therapeutic approaches such as the so-called "small molecules" or the gene replacement therapy are currently still being tested in clinical studies or are already waiting for approval by the European Medicines Agency (EMA). In this article, the most important disease-modifying drugs of SMA, the associated studies and their challenges are presented.
5号染色体相关的脊髓性肌萎缩症(SMA)迄今为止是一种病因无法治疗的疾病,由于脊髓运动神经元的丧失,会导致严重的、进行性的身体限制。然而,相对较短的编码“存活运动神经元”(SMN)1基因序列的单基因病因以及几乎相同的基因拷贝SMN2基因的存在,为新治疗方法的开发提供了有利条件。以前只能使用支持性和姑息性疗法,而现在首次有了新的疾病修正药物。反义寡核苷酸(ASO)药物诺西那生是德国首个获批用于治疗SMA的药物。其他治疗方法,如所谓的“小分子”或基因替代疗法,目前仍在临床研究中进行测试,或已在等待欧洲药品管理局(EMA)的批准。本文介绍了SMA最重要的疾病修正药物、相关研究及其面临的挑战。