Onasemnogene abeparvovec preserves bulbar function in infants with presymptomatic spinal muscular atrophy: a post-hoc analysis of the SPR1NT trial
•Bulbar function includes normal swallow, oral nutrition, and pulmonary stability.•Onasemnogene abeparvovec before SMA symptom onset preserves bulbar function.•Bulbar function should be assessed objectively and consistently in SMA. Bulbar function in spinal muscular atrophy has been defined as the a...
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| Veröffentlicht in: | Neuromuscular disorders : NMD 2023-08, Vol.33 (8), p.670-676 |
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| creator | Shell, Richard D. McGrattan, Katlyn E. Hurst-Davis, Rebecca Young, Sally Dunaway Baranello, Giovanni Lavrov, Arseniy O'Brien, Eamonn Wallach, Shiri LaMarca, Nicole Reyna, Sandra P. Darras, Basil T. |
| description | •Bulbar function includes normal swallow, oral nutrition, and pulmonary stability.•Onasemnogene abeparvovec before SMA symptom onset preserves bulbar function.•Bulbar function should be assessed objectively and consistently in SMA.
Bulbar function in spinal muscular atrophy has been defined as the ability to meet nutritional needs by mouth while maintaining airway protection and communicate verbally. The effects of disease-modifying treatment on bulbar function are not clear. A multidisciplinary team conducted post-hoc analyses of phase 3 SPR1NT trial data to evaluate bulbar function of infants at risk for spinal muscular atrophy who received one-time gene replacement therapy (onasemnogene abeparvovec) before symptom onset. Three endpoints represented adequate bulbar function in SPR1NT: (1) absence of physiologic swallowing impairment, (2) full oral nutrition, and (3) absence of adverse events indicating pulmonary instability. Communication was not assessed in SPR1NT. We descriptively assessed numbers/percentages of children who achieved each endpoint and all three collectively. SPR1NT included infants |
| doi_str_mv | 10.1016/j.nmd.2023.06.005 |
| format | Article |
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Bulbar function in spinal muscular atrophy has been defined as the ability to meet nutritional needs by mouth while maintaining airway protection and communicate verbally. The effects of disease-modifying treatment on bulbar function are not clear. A multidisciplinary team conducted post-hoc analyses of phase 3 SPR1NT trial data to evaluate bulbar function of infants at risk for spinal muscular atrophy who received one-time gene replacement therapy (onasemnogene abeparvovec) before symptom onset. Three endpoints represented adequate bulbar function in SPR1NT: (1) absence of physiologic swallowing impairment, (2) full oral nutrition, and (3) absence of adverse events indicating pulmonary instability. Communication was not assessed in SPR1NT. We descriptively assessed numbers/percentages of children who achieved each endpoint and all three collectively. SPR1NT included infants <6 postnatal weeks with two (n = 14) or three (n = 15) copies of the survival motor neuron 2 gene. At study end (18 [two-copy cohort] or 24 [three-copy cohort] months of age), 100% (29/29) of patients swallowed normally, achieved full oral nutrition, maintained pulmonary stability, and achieved the composite endpoint. When administered to infants before clinical symptom onset, onasemnogene abeparvovec allowed children at risk for spinal muscular atrophy to achieve milestones within published normal ranges of development and preserve bulbar function.</description><identifier>ISSN: 0960-8966</identifier><identifier>EISSN: 1873-2364</identifier><identifier>DOI: 10.1016/j.nmd.2023.06.005</identifier><identifier>PMID: 37455203</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Airway protection ; Bulbar function ; Onasemnogene abeparvovec ; Oral nutrition ; Spinal muscular atrophy ; Swallowing</subject><ispartof>Neuromuscular disorders : NMD, 2023-08, Vol.33 (8), p.670-676</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-c118daa631848d4909c79e9ae8f167ee940b423d582ca160ae904e708ff6fc303</citedby><cites>FETCH-LOGICAL-c396t-c118daa631848d4909c79e9ae8f167ee940b423d582ca160ae904e708ff6fc303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.nmd.2023.06.005$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37455203$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shell, Richard D.</creatorcontrib><creatorcontrib>McGrattan, Katlyn E.</creatorcontrib><creatorcontrib>Hurst-Davis, Rebecca</creatorcontrib><creatorcontrib>Young, Sally Dunaway</creatorcontrib><creatorcontrib>Baranello, Giovanni</creatorcontrib><creatorcontrib>Lavrov, Arseniy</creatorcontrib><creatorcontrib>O'Brien, Eamonn</creatorcontrib><creatorcontrib>Wallach, Shiri</creatorcontrib><creatorcontrib>LaMarca, Nicole</creatorcontrib><creatorcontrib>Reyna, Sandra P.</creatorcontrib><creatorcontrib>Darras, Basil T.</creatorcontrib><title>Onasemnogene abeparvovec preserves bulbar function in infants with presymptomatic spinal muscular atrophy: a post-hoc analysis of the SPR1NT trial</title><title>Neuromuscular disorders : NMD</title><addtitle>Neuromuscul Disord</addtitle><description>•Bulbar function includes normal swallow, oral nutrition, and pulmonary stability.•Onasemnogene abeparvovec before SMA symptom onset preserves bulbar function.•Bulbar function should be assessed objectively and consistently in SMA.
Bulbar function in spinal muscular atrophy has been defined as the ability to meet nutritional needs by mouth while maintaining airway protection and communicate verbally. The effects of disease-modifying treatment on bulbar function are not clear. A multidisciplinary team conducted post-hoc analyses of phase 3 SPR1NT trial data to evaluate bulbar function of infants at risk for spinal muscular atrophy who received one-time gene replacement therapy (onasemnogene abeparvovec) before symptom onset. Three endpoints represented adequate bulbar function in SPR1NT: (1) absence of physiologic swallowing impairment, (2) full oral nutrition, and (3) absence of adverse events indicating pulmonary instability. Communication was not assessed in SPR1NT. We descriptively assessed numbers/percentages of children who achieved each endpoint and all three collectively. SPR1NT included infants <6 postnatal weeks with two (n = 14) or three (n = 15) copies of the survival motor neuron 2 gene. At study end (18 [two-copy cohort] or 24 [three-copy cohort] months of age), 100% (29/29) of patients swallowed normally, achieved full oral nutrition, maintained pulmonary stability, and achieved the composite endpoint. When administered to infants before clinical symptom onset, onasemnogene abeparvovec allowed children at risk for spinal muscular atrophy to achieve milestones within published normal ranges of development and preserve bulbar function.</description><subject>Airway protection</subject><subject>Bulbar function</subject><subject>Onasemnogene abeparvovec</subject><subject>Oral nutrition</subject><subject>Spinal muscular atrophy</subject><subject>Swallowing</subject><issn>0960-8966</issn><issn>1873-2364</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kcuO1DAQRS0EYpqBD2CDvGSTUI7TjgMrNBoe0ohBMKytilOh3UrsYDuN-jf4YtL0wBKppNqce6Wqw9hzAaUAoV7tSz_1ZQWVLEGVANsHbCN0I4tKqvoh20CroNCtUhfsSUp7ALFtVPOYXcim3m4rkBv269ZjosmH7-SJY0czxkM4kOVzpETxQIl3y9hh5MPibXbBc3eaAX1O_KfLuz_kcZpzmDA7y9PsPI58WpJdxjWHOYZ5d3zNkc8h5WIXLMeVOCaXeBh43hH_-vmL-HTHc3Q4PmWPBhwTPbvfl-zbu-u7qw_Fze37j1dvbworW5ULK4TuEZUUutZ93UJrm5ZaJD0I1RC1NXR1JfutriwKBUgt1NSAHgY1WAnykr08984x_FgoZTO5ZGkc0VNYkqm01KpWCtSKijNqY0gp0mDm6CaMRyPAnFSYvVlVmJMKA8qsKtbMi_v6pZuo_5f4-_sVeHMGaD3y4CiaZB15S72LZLPpg_tP_W8Ydpy1</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Shell, Richard D.</creator><creator>McGrattan, Katlyn E.</creator><creator>Hurst-Davis, Rebecca</creator><creator>Young, Sally Dunaway</creator><creator>Baranello, Giovanni</creator><creator>Lavrov, Arseniy</creator><creator>O'Brien, Eamonn</creator><creator>Wallach, Shiri</creator><creator>LaMarca, Nicole</creator><creator>Reyna, Sandra P.</creator><creator>Darras, Basil T.</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230801</creationdate><title>Onasemnogene abeparvovec preserves bulbar function in infants with presymptomatic spinal muscular atrophy: a post-hoc analysis of the SPR1NT trial</title><author>Shell, Richard D. ; McGrattan, Katlyn E. ; Hurst-Davis, Rebecca ; Young, Sally Dunaway ; Baranello, Giovanni ; Lavrov, Arseniy ; O'Brien, Eamonn ; Wallach, Shiri ; LaMarca, Nicole ; Reyna, Sandra P. ; Darras, Basil T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-c118daa631848d4909c79e9ae8f167ee940b423d582ca160ae904e708ff6fc303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Airway protection</topic><topic>Bulbar function</topic><topic>Onasemnogene abeparvovec</topic><topic>Oral nutrition</topic><topic>Spinal muscular atrophy</topic><topic>Swallowing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shell, Richard D.</creatorcontrib><creatorcontrib>McGrattan, Katlyn E.</creatorcontrib><creatorcontrib>Hurst-Davis, Rebecca</creatorcontrib><creatorcontrib>Young, Sally Dunaway</creatorcontrib><creatorcontrib>Baranello, Giovanni</creatorcontrib><creatorcontrib>Lavrov, Arseniy</creatorcontrib><creatorcontrib>O'Brien, Eamonn</creatorcontrib><creatorcontrib>Wallach, Shiri</creatorcontrib><creatorcontrib>LaMarca, Nicole</creatorcontrib><creatorcontrib>Reyna, Sandra P.</creatorcontrib><creatorcontrib>Darras, Basil T.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neuromuscular disorders : NMD</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shell, Richard D.</au><au>McGrattan, Katlyn E.</au><au>Hurst-Davis, Rebecca</au><au>Young, Sally Dunaway</au><au>Baranello, Giovanni</au><au>Lavrov, Arseniy</au><au>O'Brien, Eamonn</au><au>Wallach, Shiri</au><au>LaMarca, Nicole</au><au>Reyna, Sandra P.</au><au>Darras, Basil T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Onasemnogene abeparvovec preserves bulbar function in infants with presymptomatic spinal muscular atrophy: a post-hoc analysis of the SPR1NT trial</atitle><jtitle>Neuromuscular disorders : NMD</jtitle><addtitle>Neuromuscul Disord</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>33</volume><issue>8</issue><spage>670</spage><epage>676</epage><pages>670-676</pages><issn>0960-8966</issn><eissn>1873-2364</eissn><abstract>•Bulbar function includes normal swallow, oral nutrition, and pulmonary stability.•Onasemnogene abeparvovec before SMA symptom onset preserves bulbar function.•Bulbar function should be assessed objectively and consistently in SMA.
Bulbar function in spinal muscular atrophy has been defined as the ability to meet nutritional needs by mouth while maintaining airway protection and communicate verbally. The effects of disease-modifying treatment on bulbar function are not clear. A multidisciplinary team conducted post-hoc analyses of phase 3 SPR1NT trial data to evaluate bulbar function of infants at risk for spinal muscular atrophy who received one-time gene replacement therapy (onasemnogene abeparvovec) before symptom onset. Three endpoints represented adequate bulbar function in SPR1NT: (1) absence of physiologic swallowing impairment, (2) full oral nutrition, and (3) absence of adverse events indicating pulmonary instability. Communication was not assessed in SPR1NT. We descriptively assessed numbers/percentages of children who achieved each endpoint and all three collectively. SPR1NT included infants <6 postnatal weeks with two (n = 14) or three (n = 15) copies of the survival motor neuron 2 gene. At study end (18 [two-copy cohort] or 24 [three-copy cohort] months of age), 100% (29/29) of patients swallowed normally, achieved full oral nutrition, maintained pulmonary stability, and achieved the composite endpoint. When administered to infants before clinical symptom onset, onasemnogene abeparvovec allowed children at risk for spinal muscular atrophy to achieve milestones within published normal ranges of development and preserve bulbar function.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>37455203</pmid><doi>10.1016/j.nmd.2023.06.005</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Airway protection Bulbar function Onasemnogene abeparvovec Oral nutrition Spinal muscular atrophy Swallowing |
| title | Onasemnogene abeparvovec preserves bulbar function in infants with presymptomatic spinal muscular atrophy: a post-hoc analysis of the SPR1NT trial |
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