One-Time gene therapy helps babies with deadly muscle disease sit and breathe on their own
NCT ID NCT03306277
First seen Jun 25, 2026 · Last updated Jun 27, 2026 · Updated 2 times
Summary
This phase 3 trial tested a one-time gene therapy called Zolgensma in 22 infants under 6 months old with spinal muscular atrophy (SMA) type 1, a severe muscle-weakening disease. The treatment delivers a working copy of the missing SMN gene via an IV infusion. The main goals were to see if babies could sit independently for at least 30 seconds and survive without permanent breathing support.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- Zolgensma (onasemnogene abeparvovec-xioi), a one-time gene replacement therapy given by IV infusion
- What this could lead to
- If successful, this could provide a one-time treatment that helps infants with SMA type 1 sit independently and avoid the need for permanent breathing support.
- What could go wrong
- This is a small, single-arm trial with no comparison group, so results may not apply to all patients. Gene therapy carries risks like liver injury or immune reactions, and long-term effects are still unknown.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 3
Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.
- Participants
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22 people
The number who actually took part.
- Started
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Oct 2017
- Finished
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Nov 2019
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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Up to 180 days
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Participants with SMA Type 1 as determined by the following features: a. Diagnosis of SMA based on gene mutation analysis with bi-allelic SMN1 mutations (deletion or point mutations) and 1 or 2 copies of SMN2 (inclusive of the known SMN2 gene modifier mutation (c.859G\>C))2 * The first 3 participants enrolled must meet the criteria for the Intent-To-Treat Population * Participants must be \< 6 months (\< 180 days) of age at the time of onasemnogene abeparvovec-xioi infusion * Participants must have a swallowing evaluation test performed prior to administration of gene replacement therapy * Up-to-date on childhood vaccinations. Seasonal vaccinations that include palivizumab prophylaxis (also known as Synagis) to prevent respiratory syncytial virus (RSV) infections are also recommended in accordance with American Academy of Pediatrics * Parent(s)/legal guardian(s) willing and able to complete the informed consent process and comply with study procedures and visit schedule Exclusion Criteria: * Previous, planned or expected scoliosis repair surgery/procedure during the study assessment period * Pulse oximetry \< 96% saturation at screening while the participant is awake or asleep without any supplemental oxygen or respiratory support, or for altitudes \> 1000 m, oxygen saturation \< 92% awake or asleep without any supplemental oxygen or respiratory support Pulse oximetry saturation may decrease to \< 96% after screening provided that the saturation does not decrease by ≥ 4 percentage points * Tracheostomy or current use or requirement of non-invasive ventilatory support averaging ≥ 6 hours daily over the 7 days prior to the screening visit; or ≥ 6 hours/day on average during the screening period or requiring ventilatory support while awake over the 7 days prior to screening or at any point during the screening period prior to dosing * Participants with signs of aspiration/inability to tolerate non-thickened- liquids based on a formal swallowing test performed as part of screening. Participants with a gastrostomy tube who pass the swallowing test will be allowed to enroll in the study * Participants whose weight-for-age is below the third percentile based on World Health Organization (WHO) Child Growth Standards * Active viral infection (includes human immunodeficiency virus \[HIV\] or positive serology for hepatitis B or C, or Zika virus) * Serious non-respiratory tract illness requiring systemic treatment and/or hospitalization within 2 weeks prior to screening * Upper or lower respiratory infection requiring medical attention, medical intervention, or increase in supportive care of any manner within 4 weeks prior to screening * Severe non-pulmonary/respiratory tract infection within 4 weeks before administration of gene replacement therapy or concomitant illness that creates unnecessary risks for gene replacement therapy such as: a. Major renal or hepatic impairment b. Known seizure disorder c. Diabetes mellitus d. Idiopathic hypocalcuria e. Symptomatic cardiomyopathy * Known allergy or hypersensitivity to prednisolone or other glucocorticosteroids or their excipients * Concomitant use of any of the following: drugs for treatment of myopathy or neuropathy, agents used to treat diabetes mellitus, or ongoing immunosuppressive therapy, plasmapheresis, immunomodulators such as adalimumab, immunosuppressive therapy within 3 months prior to gene replacement therapy * Anti-adeno-associated virus serotype 9 (AAV9) antibody titer \> 1:50 as determined by Enzyme-linked Immunosorbent Assay (ELISA) binding immunoassay. Should a potential participant demonstrate Anti-AAV9 antibody titer \> 1:50, he or she may receive retesting within 30 days of the screening period and will be eligible to participate if the Anti-AAV9 antibody titer upon retesting is ≤ 1:50 * Clinically significant abnormal laboratory values (gamma glutamyl- transpeptidase \[GGT\], ALT, and AST \> 3 × ULN, bilirubin ≥ 3.0 mg/dL, creatinine ≥ 1.0 mg/dL, hemoglobin \[Hgb\] \< 8 or \> 18 g/dL; white blood cell \[WBC\] \> 20,000 per cmm) prior to gene replacement therapy * Participation in recent SMA treatment clinical study (with the exception of observational Cohort studies or non-interventional studies) or receipt of an investigational or commercial compound, product, or therapy administered with the intent to treat SMA at any time prior to screening for this study. Oral β-agonists must be discontinued at least 30 days before gene therapy dosing. Inhaled albuterol specifically prescribed for the purposes of respiratory (bronchodilator) management is acceptable and not a contraindication at any time prior to screening for this study * Expectation of major surgical procedures during the study assessment period * Parent(s)/legal guardian(s) unable or unwilling to comply with study procedures or inability to travel for repeat visits * Parent(s)/legal guardian(s) unwilling to keep study results/observations confidential or to refrain from posting confidential study results/observations on social media sites * Parent(s)/legal guardian(s) refuses to sign consent form * Gestational age at birth \< 35 weeks (245 days)
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Ann and Robert H Lurie Children's Hospital
Chicago, Illinois, 60611, United States
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Boston Children's Hospital
Boston, Massachusetts, 02115, United States
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Children's Hospital Colorado
Aurora, Colorado, 80045, United States
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Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104, United States
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Columbia University
New York, New York, 10032, United States
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David Geffen School of Medicine at UCLA
Los Angeles, California, 90095, United States
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Duke University
Durham, North Carolina, 27713, United States
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Johns Hopkins Pediatric Neurology
Baltimore, Maryland, 21287, United States
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Nationwide Children's Hospital
Columbus, Ohio, 43205, United States
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Nemours Children's Hospital
Orlando, Florida, 32827, United States
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Oregon Health and Science University
Portland, Oregon, 97239, United States
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Stanford University
Stanford, California, 94305, United States
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University of Texas Southwestern Medical Center
Dallas, Texas, 75235, United States
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University of Utah
Salt Lake City, Utah, 84112, United States
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University of Wisconsin (Madison)
Madison, Wisconsin, 53792, United States
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Washington Unviersity School of Medicine
St Louis, Missouri, 63110, United States
More trials for these conditions
Other studies related to the condition(s) this trial covers.
- Can gene therapy help babies with SMA reach milestones? a Real-World review
- New study explores how families cope with feeding and talking challenges in SMA type 1
- Can a 12-Week online course help babies with SMA develop better?
- Hidden fracture risk in kids with SMA under spotlight
- Danish study reveals 10-Year trends in home ventilator use
- Gene therapy breakthrough: one dose may help babies with rare muscle disease