Health Canada Authorizes EVRYSDI? (risdiplam) for the treatment of spinal muscular atrophy (SMA) in adults and children

- FIREFISH?is an open-label, two-part study investigating the efficacy, safety, pharmacokinetics (PK) and pharmacodynamics (PD) of EVRYSDI in symptomatic Type 1 SMA patients (all patients had genetically confirmed disease with two copies of the SMN2 gene).iii
- Part 1 of FIREFISH was designed as the dose-finding part of the study. The confirmatory Part 2 of the FIREFISH study assessed the efficacy of EVRYSDI at the therapeutic dose selected based on the results from Part 1.iii
- Patients from Part 1 did not take part in Part 2. In Parts 1 and 2, the key efficacy endpoint was the ability to sit without support for at least five seconds, as measured by Item 22 of the Bayley Scales of Infant and Toddler Development ? Third Edition (BSID-III) gross motor scale, after 12 months treatment with EVRYSDI.iii
- SUNFISH?is a two-part, multicenter trial to investigate the efficacy, safety, PK and PD of EVRYSDI in SMA Type 2 or Type 3 patients between two to 25 years of age.
- Part 1 was the exploratory dose-finding portion.iii
- Part 2 was the randomized double-blind placebo-controlled confirmatory portion. Patients from Part 1 did not take part in Part 2. The primary endpoint was the change from baseline score at month 12 on the Motor Function Measure-32 (MFM32).iii
- Analysis of the data indicates 29.3 per cent of participants with infantile-onset SMA were able to sit without support for at least five seconds as measured by Item 22 of the BSID-III gross motor scale (29.3%; 90% CI:17.8%, 43.1%; p<0.0001); a key motor milestone not normally seen in the natural course of the disease. Additionally, 85.4 per cent of participants met the criteria of event-free survival without permanent ventilation (secondary endpoint) in each case after 12 months of treatment (85.4%; 90% CI:73.4%, 92.2%; p<0.0001).iii
- Analysis of the data indicates patients with later-onset SMA met the efficacy criteria of significant improvement in motor function assessed by the Motor Function Measure-32 (MFM32) (1.55 point mean difference; p<0.0156) at 12 months of treatment with EVRYSDI, compared to placebo (1.36 points [95% CI: 0.61, 2.11]; -0.19 points [95% CI: -1.22, 0.84], respectively).iii
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i?Cure SMA, "About SMA", Available at?https://www.curesma.org/about-sma/, Last accessed April 14, 2021. |
ii?Treat-NMD Neuromuscular Network, Disease Information- Spinal Muscular Atrophy, Available at?https://treat-nmd.org/treat-nmd-diseases/spinal-muscular-atrophy/?Last accessed April 14, 2021. |
iii?EVRYSDI Product Monograph, April 13, 2021. |
iv?Cure SMA Canada, "About SMA", Available at?https://curesma.ca/about-spinal-muscular-atrophy/. Last accessed April 14, 2021. |
v?Anderton RS, Mastaglia FL. Advances and challenges in developing a therapy for spinal muscular atrophy. Expert Rev Neurother. 2015;15(8):895-908. doi: 10.1586/14737175.2015.1059757. PMID: 26200127 |