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Last updated: 11th June 2024

 

The final, five-year data from the FIREFISH study of risdiplam were presented at the Cure SMA Research & Clinical Care Meeting in Austin, TX, USA (5th to 7th June, 2024).

In summary, it showed that:

  • 91% of infants treated with Evrysdi in the FIREFISH study were still alive and 81% were alive without permanent ventilation after five years of treatment.
  • Infants treated with Evrysdi maintained or continued to improve in measures of motor function: 96% of children could swallow, 80% could feed without a tube and 59% could sit without support for at least 30 seconds.
  • The study also showed overall continued reductions in serious adverse events and hospitalisations over time.

The FIREFISH study evaluated the efficacy and safety of Evrysdi in infants aged 1-7 months at the time of enrolment with Type 1 SMA. The study was in two parts:

  • Part 1: a dose-finding period
  • Part 2: evaluation of the efficacy and safety of risdiplam at the dose selected in Part 1.

Evrysdi™ is currently approved in more than 100 countries with over 15,000 patients treated globally.

For further information: Roche Update 7th June 2024

Patients enrolled via Part 1 of the trial

Patients involved in Part 1 continued to receive treatment at the dose selected from the 12-week dose-finding study.

Outcomes for infants with SMA Type 1 following 12 months of risdiplam treatment were:

  • 7 out of 17 (41%) able to sit without support for at least five seconds, compared to 0% of untreated infants (natural history data).
  • 11 (65%) able to sit (with or without support),
  • 9 (53%) achieved upright head control (assessed by HINE-2)
  • 1 (6%) achieved the milestone of standing (supporting own weight).
  • 10 out of 17 (59%) achieved a CHOP-INTEND total score of 40 points or more.
    • Median change from baseline to month 12 in CHOP-INTEND was 17.5 points.
    • The maximum CHOP-INTEND score was 57 points after 12 months treatment, increasing from a maximum of 49 points after 8 months.
    • After 16 months of treatment, 82% (14/17) of high-dose patients had a CHOP-INTEND score ≥40.
  • After 16 months of treatment, no infant required tracheostomy or reached permanent ventilation
  • 86% (18/21) of all infants were event-free after receiving risdiplam for 16 months. An event is defined as the time when ventilation support for breathing is required for at least 16 hours a day for 14 consecutive days, or sadly when a patient dies.

Patients enrolled via Part 2 of the trial

Outcomes for infants with SMA Type 1 receiving 12 months of risdiplam treatment:

  • 29% of infants (12/41; p<0.0001) able to sit without support for at least five seconds, compared to 0% of untreated infants (natural history data).
  • 18 (43.9%) able to hold their head upright.
  • 13 (31.7%) able to roll to the side.
  • 2 (4.9%) able to stand with support (measured with HINE-2).

 

  • 90% (37/41) had a CHOP-INTEND score increase of at least 4 points.
  • 56% (23/41) achieved a score above 40; the median increase was 20 points.

 

  • 85% (35/41) were event-free

2022

May: Presented at the 14th European Paediatric Neurology Society (EPNS) Congress, the data showed that 91% of infants treated with Evrysdi in were still alive at three years, and Infants treated with Evrysdi maintained or continued to improve in measures of motor function, including ability to swallow, sit without support, stand with support and walk while holding on.


2021

February: Data from part 1 of FIREFISH, were published in the New England Journal of Medicine. The study met its primary endpoint with 29% of infants sitting without support for at least five seconds by month 12, a milestone not seen in the natural course of the condition. Safety for Evrysdi™ in the FIREFISH Part 2 study was consistent with its known safety profile.

April: At the 73rd American Academy of Neurology Annual Meeting, Roche presented results demonstrating that risdiplam continued to improve motor function and survival in babies who have SMA Type 1.


2020

October: Data on Part 1 of the Firefish trial presented at the virtual 25th Annual Congress of the World Muscle Society showed that infants treated with the therapeutic dose of risdiplam continued to improve and achieve motor milestones.


2019

May: Roche reported at the 2019 American Academy of Neurology Conference that enrollment for this study was now complete and preliminary results were expected in early 2020.


2018

June: PTC Therapeutics presented preliminary data at the 2018 Cure SMA conference in Dallas indicating that risdiplam appeared to be well tolerated at all doses tested and to date had not caused any drug-related adverse events causing patient withdrawal from the trial.


2017

August: Roche had begun to enrol SMA patients in the FIREFISH Phase II trials of their splice-modifying drug, RG7916 (also known as RO7034067) in the US, Belgium, Italy, Switzerland, and Turkey.


2016

September: Roche announced that they were to begin recruiting SMA patients into this trial.