Ionis Pharma’s Alexander Disease Drug Approved

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FDA has approved Ionis Pharmaceuticals’ Zanvastro (zilganersen) injection for treating Alexander disease in pediatric and adult patients — the first approved treatment for the disease and the first therapy to directly target the protein buildup that causes it.

The rare, progressive neurological disorder is caused by mutations in the gene that produces glial fibrillary acidic protein (GFAP). “When this protein is abnormal, it accumulates in the brain’s supportive cells, causing damage to the nervous system over time,” FDA says. “The disease affects less than one in a million people and can cause a wide range of serious and potentially life-threatening problems, including seizures, loss of developmental milestones, difficulty walking, muscle weakness, and increased pressure in the brain.”

Zanvastro is described as an antisense oligonucleotide, which works by reducing abnormal GFAP protein production before it can accumulate and cause further damage. It is administered as an injection into the spinal canal every three months.

FDA says that in patients aged five years and older who had measurable difficulties with walking at baseline, those treated with Zanvastro showed significantly better walking speed at 61 weeks compared to those who received no treatment.

The most common side effects reported by those on the therapy included vomiting, back pain, cough, headache, and post-lumbar puncture syndrome, the agency says.

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