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Long-term efficacy, safety, and patient-reported outcomes of apitegromab in patients with spinal muscular atrophy: results from the 36-month TOPAZ study.

Long-term efficacy, safety, and patient-reported outcomes of apitegromab in patients with spinal muscular atrophy: results from the 36-month TOPAZ study. Frontiers in neurology Crawford, T. O., Day, J. W., De Vivo, D. C., Krueger, J. M., Mercuri, E., Nascimento, A., Pasternak, A., Mazzone, E. S., Duong, T., Song, G., Marantz, J. L., Baver, S., Yu, D., Liu, L., Darras, B. T. 2024; 15: 1419791

Abstract

Background and purpose: At 12months in the phase 2 TOPAZ study, treatment with apitegromab was associated with both an improved motor function in patients with Type 2 or 3 spinal muscular atrophy (SMA) and with a favorable safety profile. This manuscript reports the extended efficacy and safety in the nonambulatory group of the TOPAZ study at 36months.Methods: Patients who completed the primary study (NCT03921528) could enroll in an open-label extension, during which patients received apitegromab 20mg/kg by intravenous infusion every 4weeks. Patients were assessed periodically via the Hammersmith Functional Motor Scale-Expanded (HFMSE), Revised Upper Limb Module (RULM), World Health Organization (WHO) motor development milestones, Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) Daily Activities and Mobility domains, and Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue questionnaire.Results: Of the 58 patients enrolled in TOPAZ, 35 were nonambulatory (mean age 7.3years). The mean change at 36months in HFMSE score from baseline was +4.0 (standard deviation [SD]: 7.54), and+2.4 (3.24) for RULM score (excluding n=7 after scoliosis surgery). Caregiver-reported outcomes (PEDI-CAT and PROMIS Fatigue) showed improvements from baseline over 36months. In addition, most patients (28/32) improved or maintained WHO motor milestones achieved at baseline. The most frequently reported treatment-emergent adverse events were pyrexia (48.6%), nasopharyngitis (45.7%), COVID-19 infection (40.0%), vomiting (40.0%), and upper respiratory tract infection (31.4%).Conclusion: The benefit of apitegromab treatment observed at 12months was sustained at 36months with no new safety findings.

View details for DOI 10.3389/fneur.2024.1419791

View details for PubMedID 39105058