00:00The spinal muscular atrophy, SMA, is a neuromuscular pathology that affects about 1 in every 10,000 children.
00:09Before 2017, when new drugs and the possibility of doing a neonatal screening
00:13brought more than 90% to the probability of survival, it was the first cause of death of childhood in Form 1, the most serious.
00:20From the advent of drugs and treatments, I like to talk about a real Copernican revolution, or a SMA 3.0.
00:28Children with Form 1 no longer die, and I believe that this is really the great revolution,
00:34the great victory that the scientific community and the Association of Families have achieved in recent years.
00:41But then the arrival of newborn screening, and therefore of neonatal screening,
00:46has still radically and definitively subverted this situation.
00:52You have the opportunity to offer something to two young parents who have diagnosed a disease of this kind,
00:58and above all to give them a completely different quality of life compared to what it was 6-7 years ago.
01:06On the other hand, of course, it's a bit like breaking a castle.
01:10We, let's say, break what is a castle that in 9 months these two young parents built,
01:18and therefore, let's say, it is certainly a strong impact, a very strong emotional impact that must be managed,
01:25and therefore we also need the help of psychological support.
01:30We try to communicate the diagnosis together with the geneticist, but then also together with a psychological support
01:36that follows the family along the way and also in the therapeutic choice.
01:41There are many experiments in new drugs and the modalities of submonistration of those already existing.
01:46For example, the submonistration for midollo instead of that in viandra venosa.
01:49Genetic therapy, which at this time was only available for endovena submonistration for children of relatively small age and weight,
02:00is in a phase of experimentation to see the possibility of being able to adopt the same therapy,
02:06but by submonistrating it for entratical viandra, that is, directly in the midollo.
02:11This would allow to give smaller doses compared to the very large doses that should be given for a very large child or for an adult,
02:20where endovenous submonistration was done.
02:23There are also other drugs under experimentation at the moment, which are different drugs.
02:30The most obvious example is that of myostatin inhibitors,
02:34that is, drugs that, if administered, would promote muscle growth,
02:40where instead the mechanism of the pathology is to make the muscle a little smaller.
02:44In Italy, we have instituted for several years a registry called ISMAR,
02:50part of an international registry that was then expanded in Italy to cover the entire Italian network
02:57of all the centers that are recognized by the region as prescription centers for spinal muscular atrophy.
03:02Just recently, this large registry has allowed us to go and see what has happened in Italy since 2016,
03:09that is, since the year when the first drug was available for these children.
03:14And it is beautiful to see that while in the past, before the arrival of drugs,
03:19we had that only 8% of children survived beyond 2 years,
03:23now we have a percentage of children treated that is higher than 90%,
03:28not only at 2 years, but some of these children are already 7 or 8 years old.
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