Skip to content
A mother holds her daughter in a leafy area

A deeper look into SMA

Adalyne has 2 copies of SMN2 gene
Treated at ~2½ months old

SMA, or spinal muscular atrophy, is a progressive, rare genetic disease that affects the motor nerve cells in the spinal cord and impacts the muscles used for breathing, eating, crawling, and walking.

What causes SMA?

Missing or nonworking SMN1 gene

SMA is caused by the survival motor neuron 1 (SMN1) gene, which is missing or not working properly. This gene produces the survival motor neuron (SMN) protein that is critical to the function of the nerves that control our muscles.

When the SMN1 gene is missing or not working properly, the body cannot make enough SMN protein. Without enough SMN protein, select motor neuron cells throughout the body may lose their ability to function and die. As a result, people with SMA experience muscle weakness and may develop difficulty moving, breathing, swallowing, or speaking.

The role of the SMN2 backup gene

Like many genes, the SMN1 gene has a backup gene, called the survival motor neuron 2, or SMN2 gene. In people with SMA, when the SMN1 gene is missing or not working properly, the SMN2 gene can help produce SMN protein.

For people with SMA, the SMN2 gene is the main source of SMN protein production; however, it makes only about 10% of working SMN protein. ZOLGENSMA® (onasemnogene abeparvovec-xioi) delivers a new, working SMN gene to the body's cells, which then replaces the function of the SMN1 gene. This allows the cells—particularly motor neuron cells—to produce SMN protein.

People can have 1 or more copies of this backup gene and usually, the more copies of the SMN2 gene a person has, the less severe his or her SMA is. However, even people with several copies of the SMN2 gene may not produce as much SMN protein as they need, so their motor neuron cells may not work as they should.

Read more about how gene therapy treatment can stop SMA progression

Learn about SMA treatment with ZOLGENSMA

Detecting and diagnosing SMA

Staying ahead of progression

Today, SMA is usually discovered during a newborn screening. If a child tests positive for SMA, the doctor will order genetic tests to confirm the diagnosis and to see how many copies of the SMN2 backup gene the child has. They may perform additional tests to detect genetic mutations, which could indicate that the SMN1 gene is not working properly.

Whether the SMN1 gene is missing or not working, the more copies of SMN2 a person has, the less severe SMA is. And doctors can identify the number of copies before a baby shows any symptoms, which is important for early treatment.

For example, if left untreated, a baby with 2 copies of SMN2 may show symptoms sooner than a baby with 4 copies.

For babies with 4 copies or fewer, it is recommended to treat as early as
possible to stop the progression of SMA.

Before newborn screening, most children weren’t diagnosed until they showed symptoms. They were given a “type” of SMA, which classifies the severity of the disease. A child’s type was determined based on when symptoms first appeared and which motor milestones they had reached. There are four main types of SMA (Types 1-4). SMA Type 1 is the most common and is very serious. There is an additional fifth type called SMA Type 0. This is the most severe type and can be fatal before the child is born. Now that newborn screening is routine, most children are diagnosed before they are assigned a type. If you believe your child is showing symptoms of SMA but has not been diagnosed, talk to your doctor immediately or visit CureSMA.org

Due to the latest technological advances in science, doctors are able to detect SMA early and can treat before SMA can progress. For more information about types of SMA, visit CureSMA.org

How children are diagnosed

Newborn screening

Early diagnosis before signs appear through newborn screening, and early intervention with available treatments lead to better outcomes. This is especially true with SMA, where early detection and timely administration of therapies can prevent the rapid and irreversible loss of motor function caused by the disease. Today, 48 states and Washington, DC screen newborns for SMA at birth; 99% of babies born in the United States are screened in this manner.

Prenatal testing

Prenatal screening can determine if a fetus has inherited SMA and can help families prepare for treatment as early as possible. Prenatal tests for SMA include amniocentesis and chorionic villus sampling (CVS).

Showing signs of SMA

In some states, newborn screening is not routine and SMA is diagnosed when a child begins to show signs of the disease.

How SMA is inherited

SMA is an autosomal recessive disorder. This means that in order to have SMA, a person must have 2 copies of a nonworking SMN1 gene or be missing both copies of the SMN1 gene.

What is a carrier?

A carrier is a person who has 1 healthy copy and 1 nonworking copy of the SMN1 gene. A carrier generally does not show any signs or symptoms of SMA but they may pass the nonworking gene on to their children.

How can someone find out if they are a carrier?

A genetic test is the only way to know if a person is a carrier of SMA. This is done through a blood test. Partners who are thinking about becoming pregnant, or who are already pregnant can get a carrier screening for SMA and other genetic conditions. People with a family history of SMA should consider being tested. If you are interested in learning more about carrier testing, speak to a genetic counselor or your doctor.

Learn how ZOLGENSMA stops the progression of SMA

Explore now

Important Safety Information

Expand to see more

What is the most important information I should know about ZOLGENSMA?

  • ZOLGENSMA can increase liver enzyme levels and cause acute serious liver injury or acute liver failure which could result in death.
  • Patients will receive an oral corticosteroid before and after infusion with ZOLGENSMA and will undergo regular blood tests to monitor liver function.
  • Contact the patient's doctor immediately if the patient's skin and/or whites of the eyes appear yellowish, if the patient misses a dose of corticosteroid or vomits it up, or if the patient experiences a decrease in alertness.

What should I watch for before and after infusion with ZOLGENSMA?

  • Infections before or after ZOLGENSMA infusion can lead to more serious complications. Caregivers and close contacts with the patient should follow infection prevention procedures. Contact the patient's doctor immediately if the patient experiences any signs of a possible infection such as coughing, wheezing, sneezing, runny nose, sore throat, or fever.
  • Decreased platelet counts could occur following infusion with ZOLGENSMA. Seek immediate medical attention if the patient experiences unexpected bleeding or bruising.
  • Thrombotic microangiopathy (TMA) has been reported to generally occur within the first two weeks after ZOLGENSMA infusion. Seek immediate medical attention if the patient experiences any signs or symptoms of TMA, such as unexpected bruising or bleeding, seizures, or decreased urine output.
  • There is a theoretical risk of tumor development with gene therapies such as ZOLGENSMA. Contact the patient’s doctor and Novartis Gene Therapies, Inc. (1-833-828-3947) if a tumor develops.

What do I need to know about vaccinations and ZOLGENSMA?

  • Talk with the patient's doctor to decide if adjustments to the vaccination schedule are needed to accommodate treatment with a corticosteroid.
  • Protection against influenza and respiratory syncytial virus (RSV) is recommended and vaccination status should be up-to-date prior to ZOLGENSMA administration. Please consult the patient's doctor.

Do I need to take precautions with the patient's bodily waste?

Temporarily, small amounts of ZOLGENSMA may be found in the patient's stool. Use good hand hygiene when coming into direct contact with patient body waste for one month after infusion with ZOLGENSMA. Disposable diapers should be sealed in disposable trash bags and thrown out with regular trash.

What are the possible or likely side effects of ZOLGENSMA?

The most common side effects that occurred in patients treated with ZOLGENSMA were elevated liver enzymes and vomiting.

Indication

What is ZOLGENSMA?

ZOLGENSMA is a prescription gene therapy used to treat children less than 2 years old with spinal muscular atrophy (SMA). ZOLGENSMA is given as a one-time infusion into a vein. ZOLGENSMA was not evaluated in patients with advanced SMA.

The safety information provided here is not comprehensive. Talk to the patient's doctor about any side effects that bother the patient or that don't go away.

You are encouraged to report suspected side effects by contacting the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch, or Novartis Gene Therapies, Inc. at 1-833-828-3947.

Please see the FullPrescribing Information.

Tap or scroll down to read full Important Safety Information and IndicationArrow icon

Important Safety Information

What is the most important information I should know about ZOLGENSMA?

  • ZOLGENSMA can increase liver enzyme levels and cause acute serious liver injury or acute liver failure which could result in death.
  • Patients will receive an oral corticosteroid before and after infusion with ZOLGENSMA and will undergo regular blood tests to monitor liver function.
  • Contact the patient’s doctor immediately if the patient’s skin and/or whites of the eyes appear yellowish, if the patient misses a dose of corticosteroid or vomits it up, or if the patient experiences a decrease in alertness.

What should I watch for before and after infusion with ZOLGENSMA?

  • Infections before or after ZOLGENSMA infusion can lead to more serious complications. Caregivers and close contacts with the patient should follow infection prevention procedures. Contact the patient’s doctor immediately if the patient experiences any signs of a possible infection such as coughing, wheezing, sneezing, runny nose, sore throat, or fever.
  • Decreased platelet counts could occur following infusion with ZOLGENSMA. Seek immediate medical attention if the patient experiences unexpected bleeding or bruising.
  • Thrombotic microangiopathy (TMA) has been reported to generally occur within the first two weeks after ZOLGENSMA infusion. Seek immediate medical attention if the patient experiences any signs or symptoms of TMA, such as unexpected bruising or bleeding, seizures, or decreased urine output.
  • There is a theoretical risk of tumor development with gene therapies such as ZOLGENSMA. Contact the patient’s doctor and Novartis Gene Therapies, Inc. (1-833-828-3947) if a tumor develops.

What do I need to know about vaccinations and ZOLGENSMA?

  • Talk with the patient’s doctor to decide if adjustments to the vaccination schedule are needed to accommodate treatment with a corticosteroid.
  • Protection against influenza and respiratory syncytial virus (RSV) is recommended and vaccination status should be up-to-date prior to ZOLGENSMA administration. Please consult the patient’s doctor.

Do I need to take precautions with the patient’s bodily waste?

Temporarily, small amounts of ZOLGENSMA may be found in the patient’s stool. Use good hand hygiene when coming into direct contact with patient body waste for one month after infusion with ZOLGENSMA. Disposable diapers should be sealed in disposable trash bags and thrown out with regular trash.

What are the possible or likely side effects of ZOLGENSMA?

The most common side effects that occurred in patients treated with ZOLGENSMA were elevated liver enzymes and vomiting.

Indication

What is ZOLGENSMA?

ZOLGENSMA is a prescription gene therapy used to treat children less than 2 years old with spinal muscular atrophy (SMA). ZOLGENSMA is given as a one-time infusion into a vein. ZOLGENSMA was not evaluated in patients with advanced SMA.

The safety information provided here is not comprehensive. Talk to the patient’s doctor about any side effects that bother the patient or that don’t go away.

You are encouraged to report suspected side effects by contacting the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch, or Novartis Gene Therapies, Inc. at 1-833-828-3947.

Please see the Full Prescribing Information.

This website may use cookies to improve the site and your experience. See how Novartis Gene Therapies, Inc. collects, uses, and shares your personal information in our Privacy Policy.

The information provided in this site is intended only for audiences of the United States. This information does not take the place of talking to your healthcare professional about medical conditions and treatments. If you have questions about ZOLGENSMA after reading this information, ask your healthcare professional.

back to top image