Nature Medicine Publishes Results from the Pivotal DEVOTE Study of High-Dose Regimen of Nusinersen in Spinal Muscular Atrophy

Core Insights - Biogen announced the publication of results from the Phase 2/3 DEVOTE study in Nature Medicine, evaluating a high-dose regimen of nusinersen for spinal muscular atrophy (SMA) [1][2] - The high-dose regimen includes a loading dose of 50 mg/5 mL and a maintenance dose of 28 mg/5 mL, which is more rapid and higher than the previously approved 12 mg regimen [1][6] - The study demonstrated safety and effectiveness across a broad range of SMA patients, showing significant improvements in motor function and other health domains [2][3] Study Details - DEVOTE enrolled 139 participants of various ages and SMA types, with treatment-naïve infants showing statistically significant improvements in motor function compared to a matched sham group [2][3] - The pivotal cohort (Part B) reported a mean difference of 26.19 points in motor function (CHOP-INTEND) between the high-dose regimen and sham group (p<0.0001) [2] - In the open-label Part C, participants transitioning from the 12 mg regimen to the high-dose regimen experienced mean increases of 1.8 points on the Hammersmith Functional Motor Scale – Expanded (HFMSE) [3] Safety Profile - The safety profile of the high-dose regimen was consistent with the known safety profile of the 12 mg regimen, with common adverse events including pneumonia and respiratory failure [4] - In the Part B infantile-onset cohort, the most common adverse events (≥15% of participants) were pneumonia, respiratory failure, pyrexia, COVID-19, and upper respiratory tract infection [4] Regulatory Status - The high-dose regimen of nusinersen is approved in the European Union and Japan, and is currently under review by the U.S. FDA with a PDUFA action date of April 3, 2026 [5][7]