Durable vision improvement after a single treatment with antisense oligonucleotide sepofarsen: a case report.

Durable vision improvement after a single treatment with antisense oligonucleotide sepofarsen: a case report.
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DOI:
10.1038/s41591-021-01297-7
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发表时间:
2021-05
期刊:
影响因子:
82.9
通讯作者:
Girach A
Girach A
中科院分区:
医学1区
文献类型:
--
作者:
Cideciyan AV;Jacobson SG;Ho AC;Garafalo AV;Roman AJ;Sumaroka A;Krishnan AK;Swider M;Schwartz MR;Girach A

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正在通过使用反义寡核苷酸(AON)sepofarsen治疗来探索由CEP 290纤毛病变引起的Leber先天性黑蒙。在单次玻璃体内注射sepofarsen后,对属于较大队列(ClinicalTrials.gov编号NCT 03140969)的一名个体进行了15个月的研究。视觉功能和视网膜结构的一致测量在注射后近3个月达到显著的功效峰值。在15个月时,即使有证据表明从峰值反应降低,也有持续的疗效。功效动力学可以通过AON驱动的新CEP290蛋白合成的平衡和人中央凹视锥光感受器中CEP290蛋白降解的缓慢自然速率来解释。作为临床试验的一部分,使用反义寡核苷酸sepofarsen治疗的Leber先天性黑蒙患者的事后分析和随访表明,在接受单剂量药物后15个月,视力持续改善
Leber congenital amaurosis due to CEP290 ciliopathy is being explored by treatment with an antisense oligonucleotide (AON) sepofarsen. One individual who was part of a larger cohort (ClinicalTrials.gov no. NCT03140969) was studied for 15 months after a single intravitreal sepofarsen injection. Concordant measures of visual function and retinal structure reached a substantial efficacy peak near 3 months post-injection. At 15 months, there was sustained efficacy even though there was evidence of reduction from peak response. Efficacy kinetics can be explained by the balance of AON-driven new CEP290 protein synthesis and a slow natural rate of CEP290 protein degradation in human foveal cone photoreceptors. Post-hoc analyses and follow up of a patient with Leber congenital amaurosis treated with the antisense oligonucleotide sepofarsen as part of a clinical trial indicates sustained improvement of vision 15 months after a receiving a single dose of the drug
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