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用于脊髓性肌萎缩症的利司扑兰

Risdiplam for the Use of Spinal Muscular Atrophy.

作者信息

Kakazu Juyeon, Walker Nakoma L, Babin Katherine Claire, Trettin Katherine A, Lee Christopher, Sutker Patricia B, Kaye Adam M, Kaye Alan D

机构信息

Georgetown University School of Medicine, Washington DC.

Louisiana State University Health Sciences Center, Shreveport, LA.

出版信息

Orthop Rev (Pavia). 2021 Jul 12;13(2):25579. doi: 10.52965/001c.25579. eCollection 2021.

Abstract

Spinal muscular atrophy (SMA) is one of the leading causes of death in infants related to the degeneration of neurons. Currently, there are no curative treatment options for SMA, and many options available may not be feasible. This review presents the background, clinical studies, and indications for the use of Risdiplam in treating SMA. SMA causes a decrease in the production of survival motor neuron proteins (SMN) and current treatments target to increase the expression of SMN. Risdiplam is the first and only oral medication to be approved to treat SMA. As an SMN2 splicing modifier, it has provided stronger systemic therapies than previous intrathecal and gene replacement therapies. There have been many efforts to treat SMA with multidisciplinary approaches. These include intrathecal injections to gene replacement therapies. However, these have been faced with limitations such as reaching a good therapeutic dose in systemic tissues, route of administration, and price. Risdiplam is currently the only orally administered drug approved by the FDA for the treatment of SMA. It not only provides a good therapeutic window to systemic tissues but allows for a non-invasive approach in infants. Further investigation and comparison on the safety profile of Risdiplam due to its broader systemic effect should be considered with other available therapies.

摘要

脊髓性肌萎缩症(SMA)是婴儿中与神经元退化相关的主要死因之一。目前,尚无治愈SMA的治疗方案,许多现有方案可能并不可行。本综述介绍了利司扑兰治疗SMA的背景、临床研究及应用指征。SMA导致存活运动神经元蛋白(SMN)生成减少,目前的治疗旨在增加SMN的表达。利司扑兰是首个且唯一获批用于治疗SMA的口服药物。作为一种SMN2剪接修饰剂,它比以往的鞘内注射和基因替代疗法提供了更强有力的全身治疗。人们已尝试多种多学科方法来治疗SMA。这些方法包括从鞘内注射到基因替代疗法。然而,这些方法面临着一些限制,如在全身组织中达到良好治疗剂量、给药途径和价格等问题。利司扑兰是目前美国食品药品监督管理局(FDA)批准用于治疗SMA的唯一口服药物。它不仅为全身组织提供了良好的治疗窗口,还为婴儿提供了一种非侵入性的治疗方法。鉴于其更广泛的全身效应,应将利司扑兰的安全性与其他现有疗法进行进一步研究和比较。

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Risdiplam for the Use of Spinal Muscular Atrophy.用于脊髓性肌萎缩症的利司扑兰
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