Respiratory Needs in Patients with Type 1 Spinal Muscular Atrophy Treated with Nusinersen

Marika Pane, Giorgia Coratti, Roberto De Sanctis, Maria Carmela Pera, Marco Piastra, Francesco Macagno, Enrico Silvio Bertini, Eugenio Maria Mercuri

Research output: Contribution to journalArticle

Abstract

Objective To evaluate the effects of nusinersen on respiratory function of patients with type 1 spinal muscular atrophy.Study design Observational, longitudinal cohort study. We collected respiratory data from 118 children with type 1 spinal muscular atrophy and differing pulmonary requirements and conducted a semistructured qualitative interview among a subsample of caregivers at baseline, 6 months, and 10 months after the first nusinersen treatment. Patients were stratified according to ventilation modalities and age at study entry.Results Most patients in our cohort remained stable (84/109 = 77%). More than 80% of the children treated before age 2 years survived, in contrast to the lower survival reported in natural history studies, and did so without tracheostomy or noninvasive ventilation (NIV) >= 6 hours. In those less than 2 years old, only 3 patients shifted from NIV <= 10 hours to NIV >10 hours, and the other 3 reduced the hours of NIV required. Most of the older patients remained stable; this included not only those on tracheostomy or NIV >10 hours but also 75% of those on NIV <= 10 hours.Conclusions Our results suggest that nusinersen may produce some improvement in the progression of respiratory impairment, both in terms of survival and need for respiratory support >= 16 hours, especially before the age of 2 years.
Original languageEnglish
Pages (from-to)223-228
Number of pages6
JournalTHE JOURNAL OF PEDIATRICS
Volume219
DOIs
Publication statusPublished - 2020

Keywords

  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Noninvasive Ventilation
  • Oligonucleotides
  • Respiration
  • SMA1
  • Spinal Muscular Atrophies of Childhood
  • nusinersen
  • respiratory function
  • ventilation

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