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有目的地重新利用:依氟鸟氨酸治疗巴赫曼-布普综合征及其对其他多胺病的意义

Repurposing With Purpose: Treatment of Bachmann-Bupp Syndrome With Eflornithine and Implications for Other Polyaminopathies.

作者信息

Bupp Caleb P, VanSickle Elizabeth A, Michael Julianne, Schultz Chad R, Nguyen Kelly, Hoefer Melissa, Rajasekaran Surender, Bachmann André S

机构信息

Corewell Health and Helen Devos Children's Hospital, Grand Rapids, Michigan, USA.

International Center for Polyamine Disorders, Grand Rapids, Michigan, USA.

出版信息

Am J Med Genet C Semin Med Genet. 2025 Apr 1:e32138. doi: 10.1002/ajmg.c.32138.

Abstract

Rare diseases impact approximately 1 in 10 people worldwide, and yet, less than 5% of all rare diseases currently have an approved treatment option available. This is due to many challenges unique to rare diseases, including small, diverse patient populations, the cost of drug development that is not proportionate to the number of patients who could potentially benefit from treatment, and difficulty with clinical trial design to validate new therapeutics. As a result, drug repurposing has become an increasingly promising option for finding treatment options for rare diseases. First described in 2018, Bachmann-Bupp Syndrome (BABS) is a rare neurodevelopmental disorder that is caused by gain-of-function variants in the ornithine decarboxylase (ODC1) gene and is characterized by developmental delay, hypotonia, and alopecia. Through collaboration and the use of a unique drug repurposing strategy, the first patient identified with BABS was treated with the repurposed drug eflornithine, also known as α-difluoromethylornithine (DFMO), in just 16 months. Currently, five additional patients with BABS are being treated with DFMO. This model of drug repurposing of an FDA-approved drug for use in another indication can serve as an example of what is possible in the scope of other rare diseases, specifically in other polyaminopathies.

摘要

全球约十分之一的人受到罕见病影响,然而,目前所有罕见病中只有不到5%有已获批的治疗方案。这是由于罕见病特有的诸多挑战,包括患者群体规模小且多样、药物研发成本与可能从治疗中受益的患者数量不成比例,以及临床试验设计难以验证新疗法。因此,药物重新利用已成为寻找罕见病治疗方案越来越有前景的选择。巴赫曼 - 布普综合征(BABS)于2018年首次被描述,是一种罕见的神经发育障碍,由鸟氨酸脱羧酶(ODC1)基因的功能获得性变异引起,其特征为发育迟缓、肌张力减退和脱发。通过合作并采用独特的药物重新利用策略,首例确诊为BABS的患者在短短16个月内就接受了重新利用的药物依氟鸟氨酸(也称为α - 二氟甲基鸟氨酸,DFMO)治疗。目前,另有五名BABS患者正在接受DFMO治疗。这种将FDA批准药物重新用于另一种适应症的药物重新利用模式,可以作为其他罕见病,特别是其他多胺病领域可能实现的范例。

本文引用的文献

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