Wednesday, March 22, 2023

Assessment of Cardiac Safety in Patients with Friedreich’s Ataxia in the MOXIe Trial of Omaveloxolone

S.H. Subramony, MD, University of Florida Health System, David Lynch, MD, PhD, Children's Hospital of Philadelphia, Martin Delatycki, MD, PhD, Murdoch Children’s Research Institute, Angie Goldsberry, MS, Reata Pharmaceuticals, Seemi Khan, MD, Reata Pharmaceuticals, Caterina Mariotti, MD, Istituto Neurologico Carlo Besta, Katherine Mathews, MD, FAAN, University of Iowa, Colin Meyer, MD, Reata Pharmaceuticals, Masako Murai, MD, Reata Pharmaceuticals, Wolfgang Nachbauer, MD, PhD, Medical University Innsbruck, Lorenzo Nanetti, MD, Istituto Neurologico Carlo Besta, Susan Perlman, MD, University of California Los Angeles, George Wilmot, MD, PhD, Emory University School of Medicine, Theresa Zesiewicz, MD, University of South Florida Ataxia Research Center. Muscular Dystrophy Association, conference posters 2023. 

Here, we present post-hoc analyses of cardiac safety assessments performed during MOXIe Part 2. Cardiac adverse events (AEs) occurred in 9.8% of patients receiving omav (n=51) as compared to 13.5% of those receiving placebo (n=52). A standardized medical query revealed no imbalances for arrhythmia-related AEs (5 in omav group and 5 in placebo group). In patients with a medical history of cardiomyopathy, no imbalances in cardiovascular AEs were observed (12% in omav group and 13.3% in placebo group). Only one cardiac serious AE (SAE), atrial fibrillation, was reported in more than one patient, and it was reported in one patient each in placebo and omav groups. Two additional patients in the omav group reported cardiac SAEs. No clinically significant changes were observed between groups in echocardiogram, electrocardiogram, heart rate and blood pressure assessments. Slight increases in BNP and NT-Pro-BNP were observed only in the omav-treatment group but occurred without signs or symptoms of fluid retention. Mean values remained below the ULN of 100 pg/mL. Although mean cholesterol values were higher in the omav group than in the placebo group, the values remained within normal limits. The OLE trial is ongoing, with data in MOXIe accrued up to 4.3 years, as of the last data-cut of March 24th, 2022. No new cardiac safety signals have been observed. There were no deaths in the study and the majority of all adverse events were mild to moderate in severity. 
Conclusions Omav was well tolerated and had a manageable cardiac safety profile in MOXIe Part 2.

Monday, March 20, 2023

Ataxia Scales for the Clinical Evaluation

Bürk, K. (2023). Ataxia Scales for the Clinical Evaluation. In: Gruol, D.L., Koibuchi, N., Manto, M., Molinari, M., Schmahmann, J.D., Shen, Y. (eds) Essentials of Cerebellum and Cerebellar Disorders. Springer, Cham. doi:10.1007/978-3-031-15070-8_76 

The International Cooperative Ataxia Rating Scale (ICARS), the Friedreich Ataxia Rating Scale (FARS), the Scale for the Assessment and Rating of Ataxia (SARA), the Brief Ataxia Rating Scale (BARS), and the Unified Multiple System Atrophy Rating Scale (UMSARS) represent validated scales for the assessment of disease severity and progression in cerebellar disorders. Each scale has its strengths and weaknesses.

Saturday, March 18, 2023

A Novel Metric for Predicting Severity of Disease Features in Friedreich's Ataxia

Rodden, L. N., Rummey, C., Kessler, S., Wilson, R. B., & Lynch, D. R. (2023). A Novel Metric for Predicting Severity of Disease Features in Friedreich's Ataxia. Movement disorders : official journal of the Movement Disorder Society, 10.1002/mds.29370. Advance online publication. https://doi.org/10.1002/mds.29370 

FRDA DB is a novel metric of disease severity that has utility in small datasets to demonstrate correlations that would not otherwise be evident with either GAA-TR or DD alone. This is important for discovering new biomarkers, as well as improving the prediction of severity of disease features in FRDA.

Wednesday, March 15, 2023

Vesigen Therapeutics Awarded Grant from Friedreich’s Ataxia Research Alliance (FARA) to Develop a Targeted Genome Editing Therapeutic Strategy

March 14 2023. Vesigen Therapeutics, a biotechnology company developing targeted therapies by engineering a distinct class of human extracellular vesicles called ARMMs (ARrestin-domain 1 Mediated Microvesicles), is pleased to announce receipt of a FARA (Friedreich’s Ataxia Research Alliance) General Research Grant. Vesigen will evaluate its proprietary technology to deliver CRISPR-Cas genome editing complexes as a non-viral disease-modifying strategy for patients diagnosed with the neurodegenerative disease Friedreich’s Ataxia (FA).

Monday, March 6, 2023

Sensoren in der Kleidung plus KI: Erfolgversprechende Diagnosetechnologie: Bei Friedreich-Ataxie und Duchenne-Muskeldystrophie getestet

Patzer, K.-H. (2023). Sensoren in der Kleidung plus KI: Erfolgversprechende Diagnosetechnologie: Bei Friedreich-Ataxie und Duchenne-Muskeldystrophie getestet. MMW Fortschritte der Medizin, 165(S1), 46–46. doi:10.1007/s15006-023-2393-2

CRISPR/Cas9-based edition of frataxin gene in Dictyostelium discoideum for Friedreich’s Ataxia disease modeling

Gentili, H. G., Pignataro, M. F., Olmos, J., Pavan, M. F., Ibanez, L. I., Santos, J., & Velazquez, F. (2023). CRISPR/Cas9-based edition of frataxin gene in Dictyostelium discoideum for Friedreich’s Ataxia disease modeling. doi:10.1101/2023.02.27.530330

Here we present the development of a new model system for Friedreich's Ataxia (FA) using D. discoideum (Dd). FA is a rare disease caused by disfunction of frataxin (FXN), a protein involved in Fe-S cluster assembly machinery.

Reduced cerebello-cerebral functional connectivity correlates with disease severity and impaired white matter integrity in Friedreich ataxia

Kerestes, R., Cummins, H., Georgiou-Karistianis, N., Selvadurai, L. P., Corben, L. A., Delatycki, M. B., Egan, G. F., & Harding, I. H. (2023). Reduced cerebello-cerebral functional connectivity correlates with disease severity and impaired white matter integrity in Friedreich ataxia. Journal of neurology, 10.1007/s00415-023-11637-x. Advance online publication. https://doi.org/10.1007/s00415-023-11637-x

Compared to controls, people with FRDA showed significantly reduced connectivity between the anterior cerebellum and bilateral pre/postcentral gyri, and between the superior posterior cerebellum and left dorsolateral PFC. Greater disease severity correlated with lower connectivity in these circuits. Lower anterior cerebellum-motor cortex functional connectivity also correlated with slower speeded finger tapping and less fractional anisotropy in the superior cerebellar peduncles, internal capsule, and precentral white matter in the FRDA cohort. There were no significant between-group differences in inferior posterior cerebellar or dentate nucleus connectivity. This study indicates that altered cerebello-cerebral functional connectivity is associated with functional status and white matter damage in cerebellar efferent pathways in people with FRDA, particularly in motor circuits.

Saturday, March 4, 2023

Proprioceptors-enriched neuronal cultures from induced pluripotent stem cells from Friedreich ataxia patients show altered transcriptomic and proteomic profiles, abnormal neurite extension, and impaired electrophysiological properties

Dionisi, C., Chazalon, M., Rai, M., Keime, C., Imbault, V., Communi, D., Puccio, H., Schiffmann, S. N., & Pandolfo, M. (2023). Proprioceptors-enriched neuronal cultures from induced pluripotent stem cells from Friedreich ataxia patients show altered transcriptomic and proteomic profiles, abnormal neurite extension, and impaired electrophysiological properties. Brain communications, 5(1), fcad007. https://doi.org/10.1093/braincomms/fcad007

The analysis of the transcriptomic and proteomic profile suggests an impairment of cytoskeleton organization at the growth cone, neurite extension and, at later stages of maturation, synaptic plasticity. Alterations in the spiking profile of tonic neurons are also observed at the electrophysiological analysis of mature neurons. Despite the reversal of the repressive epigenetic state at the FXN locus and the restoration of FXN expression, isogenic control neurons retain many features of Friedreich ataxia neurons. Our study suggests the existence of abnormalities affecting proprioceptors in Friedreich ataxia, particularly their ability to extend towards their targets and transmit proper synaptic signals. It also highlights the need for further investigations to better understand the mechanistic link between FXN silencing and proprioceptive degeneration in Friedreich ataxia.

Sunday, February 26, 2023

Strategic discussion on funding and access to therapies targeting rare diseases in Spain: an expert consensus paper

Zozaya, N., Villaseca, J., Abdalla, F., Ancochea, A., Málaga, I., Trapero-Bertran, M., … Hidalgo-Vega, A. (2023). Strategic discussion on funding and access to therapies targeting rare diseases in Spain: an expert consensus paper. Orphanet Journal of Rare Diseases, 18(1), 41. doi:10.1186/s13023-023-02635-3

The FINEERR project may provide a starting point for stakeholders involved in the process of funding and access to RD-targeted therapies to provide the necessary resources and implement measures to improve both the quality of life and life expectancy of patients with RDs. A coordinated effort is required from the different stakeholders, including the pharmaceutical industry, with clear leadership of healthcare authorities, to allow the overall healthcare system to meet the technical, political, economic, and social challenges ahead. Future studies should explore this issue further to assess how best to implement these recommendations over time.