Czifrus Eszter, Berlau Daniel J
Semmelweis University Faculty of Medicine, Budapest, Hungary.
Department of Pharmaceutical Sciences, Regis University School of Pharmacy, Denver, CO, USA.
Expert Rev Neurother. 2023 Jul-Dec;23(10):853-858. doi: 10.1080/14737175.2023.2246658. Epub 2023 Aug 12.
Duchenne muscular dystrophy (DMD) is a progressive genetic disease leading to muscular weakness. DMD is caused by mutations of the dystrophin gene on the X chromosome that is responsible for production of dystrophin protein. Dystrophin contributes to structural support in muscle cells and mutations result in dystrophin protein deficiency which causes muscle damage and the associated clinical presentation. Exon skipping medications, including the exon 53 targeting viltolarsen, are the first agents with the ability to partially restore dystrophin protein.
Herein, the authors profile viltolarsen for the DMD patients who are amenable to exon 53 skipping therapy and provide their expert perspectives on this subject.
Current findings suggest that viltolarsen could play a role in the current and possible future treatment of DMD. Viltolarsen seems to be safe and restores dystrophin protein to around 6% of the normal level. Due to orphan drug status, after the completion of the phase 2 clinical trial, viltolarsen was granted accelerated approval in Japan and in the US. A phase 3 trial is currently in progress and needs to earn full approval. Although a multidisciplinary approach continues to be critical, the addition of exon skipping agents like viltolarsen may improve the quality of patients' lives. However, data on the long-term safety and efficacy of this medication are not yet available due to its recent accelerated approval.
杜氏肌营养不良症(DMD)是一种导致肌肉无力的进行性遗传病。DMD由X染色体上的肌营养不良蛋白基因突变引起,该基因负责肌营养不良蛋白的产生。肌营养不良蛋白有助于肌肉细胞的结构支撑,突变导致肌营养不良蛋白缺乏,进而引起肌肉损伤及相关临床表现。外显子跳跃药物,包括靶向第53外显子的维托拉森,是首批能够部分恢复肌营养不良蛋白的药物。
在此,作者概述了维托拉森对适合第53外显子跳跃疗法的DMD患者的作用,并提供了他们对此主题的专业观点。
目前的研究结果表明,维托拉森可能在DMD的当前和未来治疗中发挥作用。维托拉森似乎安全,能将肌营养不良蛋白恢复至正常水平的约6%。由于该药物为罕见病用药,在2期临床试验完成后,维托拉森在日本和美国获得了加速批准。目前正在进行3期试验,需要获得全面批准。尽管多学科方法仍然至关重要,但添加维托拉森等外显子跳跃药物可能会改善患者的生活质量。然而,由于该药物最近才获得加速批准,其长期安全性和疗效的数据尚未可得。