JEWELFISH

Ongoing commitment to SMA research in patients with previously treated SMA4

An open-label trial studying safety and tolerability4

174 adults, children, and infants (1 to 60 years of age) with Type 1, 2, or 3 SMA enrolled

  • This trial is investigating the safety, tolerability, pharmacokinetics, and pharmacodynamics of Evrysdi in both ambulatory and nonambulatory patients
    • Ambulatory and nonambulatory patients: 9% (n=15) walkers, 57% (n=100) sitters, and 34% (n=59) nonsitters
  • Participants have received previous treatment with approved or investigational therapies,* including an SMN2-splicing modifier (≥90 days prior to screening) or gene-replacement therapy (≥12 months, prior to screening)

*Investigational at the start of JEWELFISH. All but 3 patients enrolled in JEWELFISH received previous treatment; these 3 patients were previously enrolled in the MOONFISH trial, received placebo, and were never switched to RG7800.4,46

Including a broad range of age, type, and disease severity4

The study population was heterogeneous with a high degree of motor impairment at baseline

PREVIOUS TREATMENT
  RG7800* (MOONFISH)
(n=13)
Nusinersen
(n=76)
Olesoxime*
(n=71)
Onasemnogene abeparvovec
(n=14)§
All patients
(N=174)
Patient characteristics4,46
Age at enrollment, years Median (range) >18 years, % (n) 30.0 (16-58)
85% (11)
12.0 (1-60)
28% (21)
16.0 (11-36)
44% (31)
2.0 (1-5)
0%
14.0 (1-60)
36% (63)
Gender, % (n) Male 69% (9) 53% (40) 49% (35) 79% (11) 55% (95)
SMA type, % (n) 1
2
3
0%
39% (5)
62% (8)
12% (9)
57% (43)
32% (24)
3% (2)
70% (50)
27% (19)
29% (4)
71% (10)
0%
9% (15)
62% (108)
29% (51)
SMN2 copy number, % (n) 1
2
3
4
0%
8% (1)
46% (6)
46% (6)
0%
13% (10)
72% (55)
15% (11)
0%
1% (1)
92% (65)
7% (5)
21% (3)
7% (1)
71% (10)
0%
2% (3)
8% (13)
78% (136)
13% (22)
Disease severity4
Scoliosis, % (n) Yes
>40° curvature
69% (9)
23% (3)
84% (61/73)||
37% (27/73)||
93% (66)
51% (36)
27% (3/11)||
0%
83% (139/168)||
39% (66/168)||
Hip subluxation or dislocation, % (n) Yes 15% (2) 34% (25/73)|| 28% (20) 36% (4/11)|| 30% (51/168)||
Motor function assessment scores at baseline4

Motor function at baseline, % (n)
Nonsitters
Sitters
Walkers
54% (7)
23% (3)
23% (3)
28% (21)
57% (43)
16% (12)
41% (29)
59% (42)
0%
14% (2)
86% (12)
0%
34% (59)
57% (100)
9% (15)
Baseline HFMSE total score <10, % (n) Yes 62% (8) 48% (35/73)|| 83% (59) 27% (3/11)|| 63% (105/168)||

*Investigational therapies; not approved by FDA for any use.46
In the MOONFISH trial, 3 patients were treated with placebo and were not switched to RG7800.4
Three patients had also received olesoxime previously.4
§One patient received treatment with onasemnogene abeparvovec first, followed by nusinersen. Ten patients were enrolled in STRONG, three patients in STR1VE, and one patient in STR1VE EU prior to enrollment in JEWELFISH.4
||Only reported for patients aged 2 to 60 years.4
For patients younger than 2 years, baseline motor milestones were evaluated by the Hammersmith Infant Neurological Examination–Module 2.4

FDA=Food and Drug Administration; HFMSE=Hammersmith Functional Motor Scale Expanded; SMN2=survival motor neuron 2.

Understanding Evrysdi®️ and SMA support brochure icon

Overview of results from our clinical trial program

Administering and storing Evrysdi

Non-invasive options to fit your patients’ needs1,21

How Evrysdi works

 Increasing SMN protein production throughout the body1

Important Safety Information and Indication

Indication

EVRYSDI is indicated for the treatment of spinal muscular atrophy (SMA) in pediatric and adult patients.

Interactions with Substrates of MATE Transporters

  • Based on in vitro data, Evrysdi may increase plasma concentrations of drugs eliminated via MATE1 or MATE2-K, such as metformin
  • Avoid coadministration of Evrysdi with MATE (multidrug and toxin extrusion) substrates. If coadministration cannot be avoided, monitor for drug-related toxicities and consider dosage reduction of the coadministered drug if needed

Pregnancy & Breastfeeding

  • Evrysdi may cause embryofetal harm when administered to a pregnant woman. In animal studies, administration of Evrysdi during pregnancy and/or lactation resulted in adverse effects on development. Advise pregnant women of the potential risk to the fetus
  • Pregnancy testing is recommended prior to initiating Evrysdi. Advise female patients to use contraception during treatment with Evrysdi and for at least 1 month after the last dose
  • There is a pregnancy exposure registry that monitors pregnancy and fetal/neonatal/infant outcomes in women exposed to Evrysdi during pregnancy. Physicians are encouraged to register patients and pregnant women are encouraged to register themselves by calling 1-833-760-1098 or visiting https://www.evrysdipregnancyregistry.com.
  • The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Evrysdi and any potential adverse effects on the breastfed infant

Potential Effects on Male Fertility

  • Counsel male patients that fertility may be compromised by treatment with Evrysdi. Male patients may consider sperm preservation prior to treatment

Most Common Adverse Reactions

  • The most common adverse reactions in later-onset SMA (incidence in at least 10% of patients treated with Evrysdi and more frequent than control) were fever, diarrhea, and rash
  • The most common adverse reactions in infantile-onset SMA were similar to those observed in later-onset SMA patients. Additionally, adverse reactions with an incidence of at least 10% were upper respiratory tract infection (including nasopharyngitis, rhinitis), lower respiratory tract infection (including pneumonia, bronchitis), constipation, vomiting, and cough
  • The safety profile for presymptomatic patients is consistent with the safety profile for symptomatic SMA patients treated with Evrysdi in clinical trials

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Please see full Prescribing Information for additional Important Safety Information.

    • Evrysdi® (risdiplam) Prescribing Information. Genentech, Inc.

      Evrysdi® (risdiplam) Prescribing Information. Genentech, Inc.

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    • Chiriboga CA, Bruno C, Duong T, et al. JEWELFISH: 24-month results from an open-label study in non-treatment-naïve patients with SMA receiving treatment with risdiplam. J Neurol. 2024;271(8):4871-4884.

      Chiriboga CA, Bruno C, Duong T, et al. JEWELFISH: 24-month results from an open-label study in non-treatment-naïve patients with SMA receiving treatment with risdiplam. J Neurol. 2024;271(8):4871-4884.

    • Data on file. Genentech USA, Inc.

      Data on file. Genentech USA, Inc.

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      Mercuri E, Deconinck N, Mazzone ES, et al; on behalf of the SUNFISH Study Group. Safety and efficacy of once-daily risdiplam in type 2 and non-ambulant type 3 spinal muscular atrophy (SUNFISH Part 2): A phase 3, double-blind, randomised, placebo-controlled trial. Lancet Neurol. 2022;21(1):42-52.

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