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Abstract Details

Bulbar Function in Children with Two or Three SMN2 Copies Who Received Onasemnogene Abeparvovec Presymptomatically for Spinal Muscular Atrophy
Child Neurology and Developmental Neurology
P7 - Poster Session 7 (8:00 AM-9:00 AM)
4-008
We conducted a post-hoc analysis on bulbar function from a Phase III study (SPR1NT) of presymptomatic children with spinal muscular atrophy (SMA) with two (n=14) or three copies (n=15) of the SMN2 gene who received onasemnogene abeparvovec.
A goal of disease-modifying treatment for SMA is the improvement and maintenance of bulbar function, but there are no standardized and validated measures, and no widely accepted definition of bulbar function in SMA exists.

A group of experts on deglutition, respiratory function, physical therapy, nutrition, and neurology, and Novartis Gene Therapies staff defined bulbar function as the ability to establish verbal communication skills and to swallow to orally meet nutritional needs and maintain airway protection. Four endpoints were selected to represent key components of bulbar function: (1) achievement of item #6 or above on the Bayley Expressive Communication subtest, (2) receiving full oral nutrition, (3) absence of clinician-identified (clinical/fluoroscopic) markers of physiologic swallowing impairment, and (4) absence of adverse events relating to respiratory health (aspiration/aspiration pneumonia). Because communication skills were not assessed during SPR1NT, numbers/percentages of children who achieved each of the three available endpoints and all three endpoints (composite endpoint) were descriptively assessed. Last follow-up was at 18 and 24 months of age for children with two and three SMN2 copies, respectively.

Twenty-nine children were included in the analyses of three outcomes pertaining to bulbar function. At end of study, 100% (29/29) received full oral nutrition, 100% (29/29) had evidence of a normal swallow, and 100% (29/29) had no respiratory adverse events related to aspiration; 100% (29/29) met the composite endpoint. 
Presymptomatic children with SMA treated with onasemnogene abeparvovec could swallow, meet oral nutritional needs, and maintain airway protection, indicating they achieved good bulbar function and achieved motor milestones consistent with typically developing children.
Authors/Disclosures
Katlyn McGrattan, PhD, SLP (University of Minnesota)
PRESENTER
Dr. McGrattan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. McGrattan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genetech.
Richard Shell No disclosure on file
No disclosure on file
Sally Dunaway, DPT (Stanford University) Dr. Dunaway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Dunaway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Dunaway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Scholar Rock. Dr. Dunaway has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Cure SMA. The institution of Dr. Dunaway has received research support from Cure SMA. The institution of Dr. Dunaway has received research support from Scholar Rock. The institution of Dr. Dunaway has received research support from Ionis Pharmaceuticals.
Giovanni Baranello Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AveXis. Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AveXis. Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Giovanni Baranello has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AveXis. The institution of Giovanni Baranello has received research support from Great Ormond Street Hospital Charity.
Arseniy Lavrov (Novartis) Dr. Lavrov has received personal compensation for serving as an employee of Novartis. Dr. Lavrov has stock in Novartis.
No disclosure on file
Shiri Wallach Shiri Wallach has received personal compensation for serving as an employee of Novartis . Shiri Wallach has stock in Novartis .
Nicole LaMarca Ms. LaMarca has received personal compensation for serving as an employee of Novartis Gene Therapies.
Sandra P. Reyna, MD Dr. Reyna has received personal compensation for serving as an employee of Novartis Gene Therapies.
Basil T. Darras, MD (Children'S Hosp Boston Harvard Med School) The institution of Dr. Darras has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amicus. Dr. Darras has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Amicus. The institution of Dr. Darras has received research support from National Institutes of Health/National Institute of Neurological Disorders and Stroke,. The institution of Dr. Darras has received research support from Slaney Family Fund for SMA. The institution of Dr. Darras has received research support from Spinal Muscular Atrophy Foundation. The institution of Dr. Darras has received research support from CureSMA. The institution of Dr. Darras has received research support from Working on Walking Fund . The institution of Dr. Darras has received research support from CHERISH, CS2/CS12 . The institution of Dr. Darras has received research support from Biogen for CS11. The institution of Dr. Darras has received research support from AveXis. The institution of Dr. Darras has received research support from Sarepta Pharmaceuticals. The institution of Dr. Darras has received research support from PTC Therapeutics. The institution of Dr. Darras has received research support from Roche. The institution of Dr. Darras has received research support from Santhera. The institution of Dr. Darras has received research support from Scholar Rock. The institution of Dr. Darras has received research support from Fibrogen. The institution of Dr. Darras has received research support from Summit. Dr. Darras has received publishing royalties from a publication relating to health care. Dr. Darras has received publishing royalties from a publication relating to health care.