In search of a cure: The development of therapeutics to alter the progression of spinal muscular atrophy

Kristine S. Ojala, Emily J. Reedich, Christine J. Didonato, Stephen D. Meriney*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Until the recent development of disease-modifying therapeutics, spinal muscular atrophy (SMA) was considered a devastating neuromuscular disease with a poor prognosis for most affected individuals. Symptoms generally present during early childhood and manifest as muscle weakness and progressive paralysis, severely compromising the affected individual’s quality of life, independence, and lifespan. SMA is most commonly caused by the inheritance of homozygously deleted SMN1 alleles with retention of one or more copies of a paralog gene, SMN2, which inversely correlates with disease severity. The recent advent and use of genetically targeted therapies have transformed SMA into a prototype for monogenic disease treatment in the era of genetic medicine. Many SMA-affected individuals receiving these therapies achieve traditionally unobtainable motor milestones and survival rates as medicines drastically alter the natural progression of this disease. This review discusses historical SMA progression and underlying disease mechanisms, highlights advances made in therapeutic research, clinical trials, and FDA-approved medicines, and discusses possible second-generation and complementary medicines as well as optimal temporal intervention windows in order to optimize motor function and improve quality of life for all SMA-affected individuals.

Original languageEnglish (US)
Article number194
Pages (from-to)1-39
Number of pages39
JournalBrain Sciences
Volume11
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • Motoneuron disease
  • Neuromuscular disease
  • Spinal muscular atrophy
  • Therapeutics

ASJC Scopus subject areas

  • Neuroscience(all)

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