Onasemnogene abeparvovec

Onasemnogene abeparvovec, sold under the brand name Zolgensma, is a gene therapy used to treat spinal muscular atrophy (SMA),^[5][6] a disease causing muscle function loss in children. It involves a one-time infusion of the medication into a vein.^[5] It works by providing a new copy of the SMN gene that produces the SMN protein.^[5]

SMA stems from an SMN1 gene mutation, causing SMN protein deficiency vital for motor neuron survival. Onasemnogene abeparvovec, a biologic drug utilizing AAV9 virus capsids containing an SMN1 transgene, is administered to motor neurons, boosting SMN protein levels. Common side effects include vomiting and elevated liver enzymes, while more severe reactions involve liver issues and low platelet count.^[5][7]

Developed by AveXis and acquired by Novartis, onasemnogene abeparvovec gained various FDA designations and approvals globally. Controversies included data manipulation concerns and delayed reporting to regulatory agencies. Onasemnogene abeparvovec's price is high, earning it the title of the world's most expensive medication at the time of commercial approval.^[9] This has later been exceeded by other gene therapies like Hemgenix. Several countries such as Japan,^[10][11] Netherlands,^[12] Canada,^[13] Brazil^[14] and others negotiated a lower price for Zolgensma for their public healthcare systems.