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The ASCEND trial will evaluate whether treatment with a higher dose of nusinersen has the potential to improve clinical outcomes and address unmet medical needs in people with later-onset SMA who were previously treated with risdiplam. Up to 135 later-onset, non-ambulatory people with SMA aged 5-39 years will be enrolled. All participants must have been treated with the maximum dose of 5 mg of risdiplam before joining the study and be willing and able to change their treatment regimen to a higher dose of nusinersen.

Read more about trials of nusinersen and any updates, including information about access in the UK in our Nusinersen section > 

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Salanersen is similar to Spinraza (nusinersen) in that it is an "antisense oligonucleotide" (ASO). This is a small snippet of synthetic genetic material. Like Spinraza (nusinersen), salanersen is designed to target the SMN2 gene to increase the amount of SMN protein that it produces. It is a once a year injection. A Phase 1 clinical trial of Salanersen in healthy volunteers was initiated in late 2022.  This showed the drug was safe and well-tolerated. Part B of this trial was with people who had previously been treated with Zolgensma, but had a suboptimal response to the gene therapy. Interim results were published in July 2025

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This is a randomised, double-blind, sham-controlled Phase 3 study with a primary objective to evaluate the clinical efficacy, safety, and tolerability of a one-time intrathecal (IT) dose of Zolgensma in treatment naïve children and young people with Type 2 SMA who are between 2 and 18 years of age, able to sit, but have never walked.

Read more about trials of zolgensma and any updates, including information about access in the UK in our Zolgensma section > 

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SRK-015 / Apitegromab is a muscle-directed therapy that aims to reverse or restrict the muscle atrophy and weakness experienced by SMA patients. The drug is an antibody that very specifically targets an important protein called myostatin. Myostatin is naturally present in our muscles, where it plays an important role in limiting muscle growth. By inhibiting myostatin function, Apitegromab can potentially release the breaks on muscle cell growth leading to an increase in muscle size and function. If this is successful, this could benefit people who have SMA.

Read more about trials and any updates, including information about access in the UK >

Clinical trial timeline for all apitegromab trials >

GYM329 is an investigational anti-myostatin antibody that is designed to target skeletal muscles (i.e., those used for voluntary movement), potentially increasing their size and growth. Myostatin plays an important role in the regulation of skeletal muscle size by controlling growth. Inhibiting myostatin may help muscles grow in size and strength. GYM329 in combination with risdiplam, which is designed to increase the amount of SMN protein throughout the body, has the potential to further improve motor function and outcomes for people living with SMA Type 2.

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Taldefgrobep alfa is a protein designed to bind to and inhibit the function of myostatin. Myostatin is naturally present in our muscles, where it plays an important role in limiting muscle growth. By inhibiting myostatin function, taldefgrobep alfa can potentially release the breaks on muscle cell growth leading to an increase in muscle size and function. If this is successful, this could benefit people who have SMA.

Trial results >

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NMD670 is an orally-bioavailable, small molecule that specifically targets a protein called ClC-1 that is found almost exclusively on the surface of muscles cells. The function of ClC-1 is to dampen the excitability of muscles and prevent them from becoming overstimulated. By inhibiting ClC-1 function, NMD670 can increase and improve the passage of signals from motor neurons to muscles, which can increase how easily muscles are able to contract.

NMD670 is being tested in a phase 2, randomised, double-blind, placebo-controlled study in 50 ambulatory participants with SMA Type 3 that is estimated to be completed in late 2024.

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