Original Investigation

Comparative Clinical Outcomes of Nusinersen and Gene Therapy in Spinal Muscular Atrophy Type 1

JAMA Network Open 10.1001/jamanetworkopen.2025.36348

October 08, 2025 at 11:00 AM EDT

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What are the differences in clinical outcomes in children with spinal muscular atrophy (SMA) type 1 receiving first-line gene therapy vs nusinersen?In this comparative effectiveness study of 24 children in 12 matched pairs using data from the French National SMA Registry, children treated with first-line gene therapy experienced lower incidence of unsatisfactory clinical response and required less respiratory and nutritional support over time compared with those treated with first-line nusinersen, with similar motor outcomes.The findings support consideration of gene therapy as a potentially preferable treatment option in SMA type 1 and may offer evidence to guide treatment decisions.

Corresponding Author: Juliette Ropars, MD, PhD, Reference Center for Neuromuscular Disorders, Paediatric Department, University Hospital, 2 Avenue Foch, 29609 Brest, France (juliette.ropars@chu-brest.fr).

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