Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Expert Opin Investig Drugs. 2023 Jan;32(1):5-16. doi: 10.1080/13543784.2023.2173063. Epub 2023 Feb 8.
Friedreich ataxia (FRDA) is a rare autosomal recessive degenerative disorder characterized by ataxia, dysarthria, diabetes, cardiomyopathy, scoliosis, and occasionally vision loss in late-stage disease. The discovery of the abnormal gene in FRDA and its product frataxin has provided insight into the pathophysiology and mechanisms of treatment.
Although the neurologic phenotype of FRDA is well defined, there are currently no established pharmacological treatments. Omaveloxolone, a nuclear factor erythroid 2-related factor 2 (Nrf2) activator, is currently under review by the Food and Drug Administration (FDA) and has the potential to be the first approved treatment for FRDA. In the present report, we have reviewed the basic and clinical literature on Nrf2 deficiency in FRDA, and evidence for the benefit of omaveloxolone.
The present perspective suggests that omaveloxolone is a rational and efficacious therapy that is possibly disease modifying in treatment of FRDA.
弗里德赖希共济失调(FRDA)是一种罕见的常染色体隐性退行性疾病,其特征为共济失调、构音障碍、糖尿病、心肌病、脊柱侧凸,以及疾病晚期偶尔出现视力丧失。FRDA 中异常基因及其产物 frataxin 的发现为病理生理学和治疗机制提供了深入了解。
尽管 FRDA 的神经表型已得到明确界定,但目前尚无既定的药物治疗方法。核因子红细胞 2 相关因子 2(Nrf2)激活剂 omaveloxolone 目前正在接受美国食品和药物管理局(FDA)的审查,有可能成为 FRDA 的首个获批治疗药物。在本报告中,我们回顾了 Nrf2 在 FRDA 中的基础和临床文献,以及 omaveloxolone 获益的证据。
本观点表明,omaveloxolone 是一种合理且有效的治疗方法,可能对 FRDA 的治疗具有疾病修饰作用。