Core Viewpoint - Biogen Inc. announced a positive opinion from the CHMP of the EMA recommending the approval of a high dose regimen of nusinersen for treating 5q spinal muscular atrophy (SMA), with a final decision expected in January 2026 [1][7]. Company Developments - The high dose regimen of nusinersen includes a loading dose of two 50 mg doses 14 days apart, followed by a maintenance dose of 28 mg every four months for treatment-naïve patients [3][10]. - Nusinersen, marketed as SPINRAZA, is currently approved in over 71 countries at a lower dose of 12 mg [2][13]. - The high dose regimen has shown promising results in clinical studies, with significant improvements in motor function and a reduction in the risk of death or permanent ventilation [4][5]. Clinical Study Insights - The positive CHMP opinion is based on data from the Phase 2/3 DEVOTE study, which evaluated the efficacy and safety of the high dose regimen in both treatment-naïve and previously treated patients [3][11]. - In the pivotal Part B cohort of the DEVOTE study, treatment-naïve infants showed a statistically significant improvement in motor function compared to a matched sham group, with a mean difference of 26.19 points [4][11]. - The high dose regimen was generally well tolerated, with adverse events consistent with SMA and no new safety concerns identified [6][10]. Regulatory Landscape - The high dose regimen is under review by the U.S. FDA, with a decision expected by April 3, 2026 [9]. - Biogen is actively working with regulatory authorities worldwide to advance the high dose regimen as an additional option for SMA patients [9].

Core Viewpoint - Biogen Inc. has successfully acquired Alcyone Therapeutics, enhancing its capabilities in innovative CNS therapy delivery solutions, particularly through the ThecaFlex DRx™ drug delivery system [1][4]. Company Overview - Biogen is a leading biotechnology company founded in 1978, focused on pioneering innovative science to deliver new medicines and create value for shareholders and communities [10]. - The company emphasizes a deep understanding of human biology and leverages various modalities to advance first-in-class treatments [10]. Acquisition Details - The acquisition of Alcyone Therapeutics is aimed at strengthening Biogen's portfolio and expanding its expertise in drug delivery methods [4]. - The ThecaFlex DRx™ system is designed to provide an alternative to repeated lumbar punctures for chronic intrathecal administration of medicines, potentially improving patient experience and accessibility [2][5]. ThecaFlex DRx™ System - The ThecaFlex DRx™ is an investigational implantable device that allows access to cerebrospinal fluid for therapy infusion, representing a significant advancement over the current standard of care [5]. - The system has received a CE Mark in Europe and an Investigational Device Exemption from the FDA, although it is not yet approved for commercial use in the U.S. [5]. Clinical Development - ThecaFlex DRx™ has been in development since 2019, with ongoing clinical studies for nusinersen, marketed as SPINRAZA, which treats spinal muscular atrophy (SMA) [3]. - Biogen plans to introduce the new drug delivery system for SPINRAZA in early 2028, pending successful clinical trials and regulatory approval [3]. SPINRAZA Overview - SPINRAZA (nusinersen) is approved in over 71 countries for treating SMA, with more than 14,000 individuals treated globally [6]. - The drug has demonstrated efficacy across various ages and SMA types, supported by a well-established safety profile [7]. Regulatory Updates - A high dose regimen of SPINRAZA has recently been approved in Japan and is under review by the European Medicines Agency and the FDA, with a decision expected by April 3, 2026 [9].

Group 1 - Biogen Inc. is considered one of the most undervalued stocks on NASDAQ, with a recent acquisition of Alcyone Therapeutics for an initial cash payment of $85 million and additional milestone payments [1] - The acquisition centers on ThecaFlex DRx, an implantable device aimed at providing chronic medication delivery for patients with neurological illnesses, eliminating the need for repeated lumbar punctures [2] - Following the acquisition, Biogen will oversee the development, production, and marketing of ThecaFlex DRx, with ongoing clinical studies assessing its effectiveness in patients with spinal muscular atrophy using SPINRAZA (nusinersen) [3]

Core Viewpoint - Biogen Inc. received a Complete Response Letter (CRL) from the FDA regarding its supplemental New Drug Application (sNDA) for a high dose regimen of nusinersen for spinal muscular atrophy (SMA), requesting updates to the technical information in the Chemistry Manufacturing and Controls (CMC) module [1][2] Group 1: FDA Response and Company Actions - The FDA's letter did not indicate any deficiencies in the clinical data for the high dose regimen [2] - Biogen plans to promptly resubmit the application based on readily available information [2] - The company is collaborating with global regulatory authorities to advance the high dose regimen as an additional option for SMA patients [2] Group 2: Product Information - SPINRAZA (nusinersen) is approved in over 71 countries for treating SMA in infants, children, and adults, with more than 14,000 individuals treated worldwide [3] - The drug has demonstrated efficacy across various ages and SMA types, supported by a well-established safety profile from data in patients treated for up to 10 years [4] Group 3: Company Background - Biogen, founded in 1978, is a leading biotechnology company focused on innovative science to develop new medicines and create value for shareholders and communities [6]

Core Insights - Biogen announced new data reinforcing the clinical impact of nusinersen for spinal muscular atrophy (SMA), highlighting findings from the DEVOTE trial and NURTURE trial presented at a recent conference [1][6][8] - The higher dose regimen of nusinersen is under review in multiple global markets, featuring a rapid loading and higher maintenance dosing schedule [1][5] DEVOTE Trial Findings - Part C of the DEVOTE trial demonstrated potential clinical benefits of a higher dose of nusinersen in previously treated patients (n=38) aged 4 to 65, with a median treatment duration of approximately 3.9 years [3][4] - Improvements were observed in motor function across various assessments, with non-ambulatory participants showing an average improvement of +2.5 on the Hammersmith Functional Motor Scale – Expanded (HFMSE) [4][5] NURTURE Study Outcomes - Final data from the NURTURE study indicated that all 25 participants remained alive, with no need for permanent ventilation, and 92% achieved independent walking ability [6][7][8] - Participants with elevated neurofilament light chain (NfL) levels at baseline showed significant reductions in NfL after starting nusinersen, suggesting its potential as a biomarker for treatment response [9] Safety Profile - The safety profile of the higher dose regimen aligns with the known safety profile of the 12 mg SPINRAZA, with most adverse events reported as mild to moderate [5][9] - In the DEVOTE study, 37 out of 40 participants reported adverse events, with serious adverse events occurring in 15% of participants, none related to the treatment [5]

Core Insights - Biogen Inc. announced topline results from the Phase 1 study of salanersen, an antisense oligonucleotide for spinal muscular atrophy (SMA), showing potential for high efficacy and once yearly dosing [1][5] - The Phase 1 study demonstrated substantial slowing of neurodegeneration and clinically meaningful improvements in motor function in children previously treated with gene therapy [2][5] - Biogen is engaging with global health authorities to advance salanersen into registrational studies based on encouraging Phase 1 data [4][5] Study Details - The Phase 1 study included two parts: a randomized placebo-controlled segment in healthy adults and an open-label segment in pediatric SMA participants who had previously received ZOLGENSMA [2][4] - Interim results from the open-label segment (n=24) indicated that both 40 mg and 80 mg doses of salanersen were well-tolerated, with a mean reduction in neurofilament light chain (NfL) of 70% at 6 months [2][4] - Exploratory data showed that half of the participants (4 out of 8) achieved new WHO motor milestones after receiving salanersen [3][4] Safety Profile - The safety profile of salanersen was generally well-tolerated, with most adverse events being mild to moderate, including pyrexia and upper respiratory tract infections [4][5] - The study's findings suggest that salanersen could address critical unmet needs in SMA treatment, building on Biogen's extensive experience in the field [3][5] Industry Context - SMA is a rare genetic neuromuscular disease affecting approximately 1 in 10,000 live births, characterized by progressive muscle atrophy and weakness [7][8] - SPINRAZA, another treatment for SMA, has been approved in over 71 countries and has treated more than 14,000 individuals worldwide, establishing a foundation of care in SMA [9][10]