Quality of Life in SMA Patients Under Treatment With Nusinersen.

Lucas Mix,Simon Witzel,Zeljko Uzelac,Albert C Ludolph,Heiko Graf,Sophia Platen,Dorothée Lulé,Benedikt Winter,Claudia D Wurster

doi:10.3389/fneur.2021.626787

Abstract

Background: Spinal Muscular Atrophy (SMA) is a severe neurodegenerative disease, characterized by progressive muscle weakness and atrophy. The approval of the antisense oligonucleotide (ASO) nusinersen now provides an effective pharmacological approach with the potential to slow down or stop disease progression with a potentially major impact on patients' well-being.Objective: This study evaluates quality of life (QoL) in pediatric and adult patients over the course of therapy with nusinersen.Methods: Twenty-six SMA patients treated with nusinersen were evaluated regarding global QoL (gQoL), health-related QoL (HRQoL) and depressiveness. Assessments were conducted three times over the first 6 months of treatment. Applied were different questionnaires: the Anamnestic Comparative Self-Assessment (ACSA) for gQoL, the Short Form-36 Health Survey (SF-36) for HRQoL in adult patients and the ALS Depression Inventory 12 Items (ADI-12) for depressiveness. The sample was matched with 22 healthy controls.Results: Despite severe physical restrictions, patients reported high levels of QoL and low levels of depressiveness at study entry. Early disease onset and low levels of physical functioning were associated with better gQoL and lower levels of depressiveness. A significant decrease of gQoL in patients was evident over the course of the study. Still, adult patients reported a significant increase in perceived health.Conclusions: Our study provides first insight that SMA patients experience a gQoL superior to healthy controls at start of therapy. This might indicate patients' high hopes and expectations toward treatment. gQoL returns to a level similar to that of healthy controls over the course of therapy.

Highlights

Spinal muscular atrophy (SMA) is a severe inheritable neurodegenerative disease with childhood onset (SMA type I-III) that is typically characterized by progressive muscle weakness and atrophy
This changed with the approval of the antisense oligonucleotide (ASO) nusinersen for the treatment of 5q-associated SMA types and its considerable efficacy to modify the course of the disease [1]
No significant differences in qQoL at study entry could be found between SMA types I, II and III or between “walkers,” “sitters” and “nonsitters.”

Summary

Introduction

Spinal muscular atrophy (SMA) is a severe inheritable neurodegenerative disease with childhood onset (SMA type I-III) that is typically characterized by progressive muscle weakness and atrophy. Treatment options in SMA were restricted to supportive care This changed with the approval of the antisense oligonucleotide (ASO) nusinersen for the treatment of 5q-associated SMA types and its considerable efficacy to modify the course of the disease [1]. One study even reported better mental health in SMA patients with severe motor disability compared to those with milder symptoms [10]. It has been shown, that physical function and self-reported QoL have no association in children and adolescents with SMA [6]. The approval of the antisense oligonucleotide (ASO) nusinersen provides an effective pharmacological approach with the potential to slow down or stop disease progression with a potentially major impact on patients’ well-being

Methods

Results

Conclusion