AMONDYS 45(卡西莫森),一种新型反义磷酰二胺吗啉代寡聚物:杜氏肌营养不良症治疗的临床考量
AMONDYS 45 (Casimersen), a Novel Antisense Phosphorodiamidate Morpholino Oligomer: Clinical Considerations for Treatment in Duchenne Muscular Dystrophy.
作者信息
Vasterling Megan E, Maitski Rebecca J, Davis Brice A, Barnes Julie E, Kelkar Rucha A, Klapper Rachel J, Patel Hirni, Ahmadzadeh Shahab, Shekoohi Sahar, Kaye Alan D, Varrassi Giustino
机构信息
School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.
School of Medicine, Medical University of South Carolina, Charleston, USA.
出版信息
Cureus. 2023 Dec 28;15(12):e51237. doi: 10.7759/cureus.51237. eCollection 2023 Dec.
AMONDYS 45 (casimersen) is an antisense oligonucleotide therapy used to treat Duchenne muscular dystrophy (DMD), a rare genetic disorder characterized by a mutation in the DMD gene. Symptoms include progressive muscle weakness, respiratory and cardiac complications, and premature death. Casimersen targets a specific mutation in the DMD gene that results in the absence of dystrophin protein, a key structural component of muscle fibers. While there is currently no cure for DMD, exon-skipping therapy works by restoring the reading frame of the mutated gene, allowing the production of a partially functional dystrophin protein. Clinical trials of casimersen have shown promising results in increasing dystrophin production, as measured by polymerase chain reaction (PCR) droplets when compared to placebo. In a randomized double-blind trial, patients who received casimersen had significantly higher dystrophin levels when compared to those who received placebo. Casimersen therapy is administered through repeated intravenous infusions, although the optimal dosage and duration of treatment are still under investigation. Based on the completed and ongoing clinical trials, casimersen has been well tolerated, with most adverse events being mild and unrelated to casimersen. In 2021, AMONDYS 45 (casimersen) received approval from the US Food and Drug Administration (FDA) for the treatment of Duchene muscular dystrophy in patients with a mutation of the DMD gene that is amenable to exon 45 skipping. These collective findings indicate that casimersen has the potential to elicit functional changes in individuals with DMD, although further studies are necessary to comprehensively evaluate the specific functional improvements. Regardless, the FDA approval and ongoing clinic trials mark a significant milestone in the development of DMD treatments and offer hope for those affected by this debilitating disease.
AMONDYS 45(卡西莫森)是一种反义寡核苷酸疗法,用于治疗杜氏肌营养不良症(DMD),这是一种罕见的遗传性疾病,其特征是DMD基因突变。症状包括进行性肌肉无力、呼吸和心脏并发症以及过早死亡。卡西莫森靶向DMD基因中的特定突变,该突变导致肌营养不良蛋白缺失,而肌营养不良蛋白是肌纤维的关键结构成分。虽然目前尚无治愈DMD的方法,但外显子跳跃疗法的作用是恢复突变基因的阅读框,从而产生部分功能性的肌营养不良蛋白。卡西莫森的临床试验显示,与安慰剂相比,通过聚合酶链反应(PCR)液滴测量,在增加肌营养不良蛋白产生方面取得了有希望的结果。在一项随机双盲试验中,接受卡西莫森治疗的患者与接受安慰剂的患者相比,肌营养不良蛋白水平显著更高。卡西莫森疗法通过重复静脉输注给药,尽管最佳剂量和治疗持续时间仍在研究中。根据已完成和正在进行的临床试验,卡西莫森耐受性良好,大多数不良事件为轻度且与卡西莫森无关。2021年,AMONDYS 45(卡西莫森)获得美国食品药品监督管理局(FDA)批准,用于治疗DMD基因发生适合45号外显子跳跃突变的杜氏肌营养不良症患者。这些综合研究结果表明,卡西莫森有可能在DMD患者中引发功能变化,不过还需要进一步研究来全面评估具体的功能改善情况。无论如何,FDA的批准和正在进行的临床试验标志着DMD治疗发展中的一个重要里程碑,并为受这种使人衰弱疾病影响的患者带来了希望。
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