Management and Treatment of Spinal Muscular Atrophy

There’s no cure for spinal muscular atrophy (SMA). But there are treatments.

Many of them focus on:

  • Easing symptoms
  • Preventing complications
  • Improving quality of life

Two medications can help slow down SMA symptoms. In some cases, they may be able to stop the disease from getting worse. But they aren’t an option for everyone.

There are different types of SMA. Even people who have the same type of SMA can have different symptoms. So treatment can vary widely from person to person.

If you have SMA, you’ll be treated by many doctors with different specialties. Your team will work together to come up with the best treatment plan for you.

Here’s what you need to know.

Medications

The FDA has approved two medications to treat SMA:

  • Nusinersen (Spinraza)
  • Onasemnogene abeparvovec-xioi (Zolgensma)

Both of these medicines are types of gene therapy. That means they target the genes that play a role in SMA. (Genes are like blueprints in your body that tell your cells how to work.) SMA is almost always caused by a mutation to either the SMN1 or SMN2 gene. These tell your body to make proteins that help control muscle movement. When one of these genes is mutated, your muscles don’t grow and work the way they should.

Spinraza is for children and adults with a mutation in the SMN1 gene. The medicine is injected one time into your spinal canal, the area that houses your spinal cord.  It uses a man-made genetic material called antisense oligonucleotide to help your body make more SMN proteins. Those extra proteins help your muscles work better and ease symptoms.

Because it’s such a new treatment, experts aren’t sure how long Spinraza works. They do know that children who get it early in their lives tend to have the best results.  

Zolgensma is for children younger than 2 years old. It’s also a one-time medication. But this one is given by an IV into a vein.

The medicine puts a virus into your body that includes a replacement gene. The virus gives your cells new DNA to replace the missing or mutated gene. That helps your motor neurons work better. It also eases symptoms and may help you live longer.

Like Spinraza, the earlier people with SMA start to take Zolgensma, the more effective it’s likely to be.

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Other Treatments

Your doctor might also recommend:

Breathing help. Because SMA can affect your airways and lungs, you may need therapy to help make them stronger. That can help you breathe better. You may need a suction machine to get rid of mucus and clear the back of your throat. If your case is more severe, you might need a machine that helps you breathe with the help of a mask or mouthpiece.

Dietary help. Children with SMA may have a hard time getting the nutrients they need to grow. Their doctor may recommend that they work with a dietitian. Your child may need a feeding tube to help them eat, especially if they’re having trouble swallowing or eating. Feeding tubes can go through the nose and down the throat, or go directly into the stomach through an opening.

Physical and occupational therapy. Therapists can teach you exercises and stretches that can strengthen and stretch stiff muscles and joints. They can also help you or your child find and use equipment that makes moving easier, like braces, shoe inserts, a walker, or wheelchair.

Treatments for spine problems. Some children with SMA get scoliosis, an unusually curved spine. If you or your child has scoliosis, your doctor may recommend a back brace or surgery to help the spine grow correctly.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on December 19, 2019

Sources

SOURCES:

Boston Children’s Hospital: “Spinal Muscular Atrophy (SMA) | Diagnosis & Treatment.”

Cleveland Clinic: “Spinal Muscular Atrophy (SMA): Management and Treatment.”

National Health Service (NHS) U.K.: “Treatment: Spinal Muscular Atrophy.”

Children’s Hospital of Philadelphia: “Spinal Muscular Atrophy (SMA).”

Cure SMA: “Treatment,” “Zolgensma.”

FDA.org: “Zolgensma (Package Insert).”

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