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Onasemnogene Abeparvovec-xioi

Phase 3

SMA | Monoclonal antibody | Neurology |Novartis AG|Last Updated: Jan 26, 2026

Target and mechanism

Molecular targetSMN2, SMN1
Target classExogenous Gene
ModalityMonoclonal antibody

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLEDDMC
Total Trials1
Total Enrollment33

FDA Designations

No designations recorded

Clinical trial landscape

Onasemnogene Abeparvovec-xioi · 5 trials · 7 indications

Phase 3 5
NCT04042025Long-term Follow-up Study of Patients Receiving Onasemnogene Abeparvovec-xioiSpinal Muscular Atrophy Type I
ACTIVE NOT_RECRUITING85 Analytics
NCT03837184Single-Dose Gene Replacement Therapy Using for Patients With Spinal Muscular Atrophy Type 1 With One or Two SMN2 CopiesSpinal Muscular Atrophy Type I
COMPLETED2 Analytics
NCT03461289Single-Dose Gene Replacement Therapy Clinical Trial for Participants With Spinal Muscular Atrophy Type 1SMA
COMPLETED33 Analytics
NCT03505099Pre-Symptomatic Study of Intravenous Onasemnogene Abeparvovec-xioi in Spinal Muscular Atrophy (SMA) for Patients With Multiple Copies of SMN2Spinal Muscular Atrophy
COMPLETED30 Analytics
NCT03306277Gene Replacement Therapy Clinical Trial for Participants With Spinal Muscular Atrophy Type 1SMA - Spinal Muscular Atrophy
COMPLETED22 Analytics
PHASE3ACTIVE NOT_RECRUITING
Long-term Follow-up Study of Patients Receiving Onasemnogene Abeparvovec-xioi
Spinal Muscular Atrophy Type IUnlock trial analytics
PHASE3COMPLETED
Single-Dose Gene Replacement Therapy Using for Patients With Spinal Muscular Atrophy Type 1 With One or Two SMN2 Copies
Spinal Muscular Atrophy Type IUnlock trial analytics
PHASE3COMPLETED
Single-Dose Gene Replacement Therapy Clinical Trial for Participants With Spinal Muscular Atrophy Type 1
SMAUnlock trial analytics
PHASE3COMPLETED
Pre-Symptomatic Study of Intravenous Onasemnogene Abeparvovec-xioi in Spinal Muscular Atrophy (SMA) for Patients With Multiple Copies of SMN2
Spinal Muscular AtrophyUnlock trial analytics
PHASE3COMPLETED
Gene Replacement Therapy Clinical Trial for Participants With Spinal Muscular Atrophy Type 1
SMA - Spinal Muscular AtrophyUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants Who Reach Developmental Milestones
Up to 5 years

Assessed via the developmental milestone checklist, formed of 10 yes/no questions. The developmental milestones are: head control, sitting with support, sitting without support, sitting without support for 30 seconds, hands-and-knees crawling, pulls to stand, standing with assistance, walking with assistance, standing alone and walking alone.

Change From Baseline in Hammersmith Functional Motor Scale - Expanded (HFMSE) Score
Up to 5 years

The HFMSE was devised for use in children with SMA to give objective information on motor ability and clinical progression. The HFMSE is formed of 33 assessments rated from 0 (unable to perform functional task) to 2 (able to perform functional task unassisted). Higher scores on the total scale of 0-66 indicates higher levels of motor ability.

Number of Participants Who Experience a Clinically Significant Change From Baseline in Pulmonary Assessment Results and Require Ventilatory Support
Up to 15 years

Participants will receive pulmonary assessments by a pulmonologist or appropriate clinician. Respiratory device data will be reviewed for participants receiving non-invasive ventilatory support.

Number of Participants Who Experience Swallowing Dysfunction and Require Nutritional Support
Up to 5 years

Assessed via the swallowing function questionnaire, formed of 4 yes/ no questions and 1 body weight question.

Number of Participants Who Experience a Clinically Significant Change from Baseline in Physical Examination Findings
Up to 5 years

The physical examination includes review of the following systems: head, ears, eyes, nose and throat, lungs/thorax, cardiovascular, abdomen, musculoskeletal, neurologic, dermatologic, lymphatic, and genitourinary. In addition, visual inspection of the spine, back, shoulders, and hips looking for spinal curvature and asymmetry will be carried out. Joints will be assessed for loss of mobility and contractures.

Number of Participants Who Experience a Clinically Significant Change From Baseline in Vital Signs Measurements
Up to 5 years

Vital sign measurements will include blood pressure, respiratory rate, pulse, axillary temperature, and pulse oximetry.

Change From Baseline in Height Measurements
Up to 5 years
Change From Baseline in Weight Measurements
Up to 5 years
Number of Participants Who Experience a Clinically Significant Change From Baseline in Clinical Laboratory Assessments
Up to 5 years

Blood samples will be collected for hematology (including complete blood cell count) and chemistry.

Number of Participants Who Experience a Clinically Significant Change From Baseline in Cardiac Assessments
Up to 5 years

Cardiac assessments will include a 12-lead electrocardiogram, transthoracic echocardiogram and Troponin-I.

Number of Participants Who Experience a Clinically Significant Change From Baseline in Observational Phase Questionnaire Results
Year 6 to Year 15

The observational phase questionnaire includes 7 yes/no questions. Observation categories include: adverse events, hospitalizations, concomitant medications, ventilatory support and feeding support.

Number of Participants Who Experience at Least One Serious Adverse Event (SAE)
Up to 15 years

An SAE is defined as any adverse event (appearance of \[or worsening of any pre existing\]) undesirable sign(s), symptom(s), or medical conditions(s) which meets any one of the following criteria: * Fatal * Life-threatening * Results in persistent or significant disability/incapacity * Constitutes a congenital abnormality or birth defect * Requires in-patient hospitalization or prolongation of existing hospitalization * Is medically significant e.g. defined as an event that jeopardizes the participant or may require medical or surgical intervention to prevent one of the outcomes listed above

Number of Participants Who Experience at Least One Adverse Event of Special Interest (AESI)
Up to 15 years

An AESI is defined as an AE occurring during any study phase that fulfills one of the following criteria: * Hepatotoxicity * Thrombotic microangiopathy * Cardiac adverse events * Dorsal root ganglia toxicity * New malignancies * New incidence of a neurologic disorder * New incidence of an autoimmune disorder * New incidence of hematologic disorder

Change From Baseline in Bayley Scales of Infant and Toddler Development
Up to 42 months, 15 days of age

Third Edition (Bayley-III) to be performed in all patients up to 42 months, 15 days of age.

Change From Baseline in Revised Upper Limb Module (RULM) Score
Up to 5 years

RULM score is based on a scale from 0 to 37 where lower scores reflect poorer upper limb functional ability.

Change From Baseline in Cogstate Computerized Cognitive Battery Performed in Age 48 Months and Older
Up to 5 years

The Cogstate Computerized Cognitive Battery consists of the Identification Test (scored 0 (best) to 1.5708 (worst)), the International Shopping List Test (scored 0 (worst) to 999 (best)), the International Shopping List Test-Delayed Recall (scored 0 (worst) to 999 (best)), the One Card Learning Test (scored 0 (worst) to 1.5708 (best)), and the One Back Test (scored 0 (worst) to 1.5708 (best)).

Change From Baseline in Clinical Evaluation of Language Fundamentals Fifth Edition (CELF-5) Performed in All Participants 5 to 21 Years of Age
Up to 5 years

The CELF-5 Following Directions and Sentence Repetition subtests use scoring that varies based on age, but will be administered to participants 5-21 years of age. The Following Directions subtest will be scored from 0-33 with higher score being more advanced and the Recalling Sentences subtest will be scored from 0-78 with higher score being more advanced.

Change From Baseline in Assessment of Caregiver Experience With Neuromuscular Disease (ACEND)
Up to 5 years

ACEND score is based on a scale from 1 to 41 where higher scores represent a better caregiver experience

Number of Participants With Concomitant Medications Overall and by Type of Medications
Up to 5 years
Number of Participants With Other SMA Therapies Overall and by Type of Medications
Year 6 to Year 15
Number of Participants Who Achieved Sitting Alone for at Least 10 Seconds
From Baseline up to 18 Months of Age Visit

Independent sitting is defined by the World Health Organization Multicentre Growth Reference Study, confirmed by video recording, as a participant who sits up straight unsupported for at least 10 seconds.

Number of Participants Who Achieve Independent Sitting for at Least 10 Seconds
From Day 1 up to 18 Months of Age Visit (Up to a Maximum of Approximately 17 Months)

Independent sitting is defined by the World Health Organization Multicentre Growth Reference Study, confirmed by video recording, as a participant who sits up straight with head erect for at least 10 seconds; participant does not use arms or hands to balance body or support position.

Cohort 1: Number of Participants Who Achieved Sitting Alone for at Least 30 Seconds
From Day 1 up to 18 months of age visit

Defined by the Bayley Scales of Infant and Toddler Development (BSID) Gross Motor (GM) subtest performance criteria number 26, confirmed by video recording, as a participant who sits for at least 30 seconds without assistance from another person or object. The participant was allowed to use their upper extremities.

Cohort 2: Number of Participants Who Achieved Standing Alone for at Least 3 Seconds
From Day 1 up to 24 months of age visit

Defined by the BSID GM subtest performance criteria number 40, confirmed by video recording, as a participant who stands alone for at least 3 seconds unsupported.

Achievement of Independent Sitting for at Least 30 Seconds
Up to 18 months

Independent sitting is defined as sitting up straight with head erect for at least 30 seconds. This endpoint is a co-primary endpoint. The two co-primary efficacy endpoints were assessed in sequence: The endpoint of functional independent sitting was assessed first and, only when this assessment met statistical significance, was the endpoint of event-free survival assessed.

Event-free Survival
14 months

Survival is defined by the avoidance of combined endpoint of either death or permanent ventilation, which is defined by tracheostomy or by the requirement of ≥ 16 hours of respiratory assistance per day for ≥ 14 consecutive days in the absence of an acute reversible illness, excluding perioperative ventilation. Permanent ventilation is considered a surrogate for death. An acute reversible illness is defined as any condition other than SMA that results in increased medical intervention. The endpoint is a co-primary endpoint. The two co-primary efficacy endpoints were assessed in sequence: The endpoint of functional independent sitting was assessed first and, only when this assessment met statistical significance was the survival endpoint assessed.

Secondary Endpoints

Event-free Survival at 14 Months of Age
From Baseline up to 14 Months of Age
Cohort 1: Event-free Survival at 14 Months of Age
From Day 1 up to 14 months of age
Cohort 1: Number of Participants Who Achieved the Ability to Maintain Weight at or Above the Third Percentile Without the Need for Non-Oral or Mechanical Feeding Support
From Day 1 up to 18 months of age
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Intravenous (IV) & Intrathecal (IT) Onasemnogene Abeparvovec-xioiOTHERParticipants received treatment with IV onasemnogene abeparvovec-xioi in an onasemnogene abeparvovec-xioi or received treatment with IT onasemnogene abeparvovec-xioi in an onasemnogene.
Onasemnogene Abeparvovec-xioiEXPERIMENTALParticipants will receive a single dose of onasemnogene abeparvovec-xioi, administered intravenously.

Interventions

NameTypeDescription
Onasemnogene Abeparvovec-xioiBIOLOGICALOnasemnogene abeparvovec-xioi is a non-replicating recombinant adeno-associated virus serotype 9 containing the human survival motor neuron gene under the control of the cytomegalovirus enhancer/chicken β-actin-hybrid promoter. Onasemnogene abeparvovec-xioi administered as a one-time intravenous (IV) infusion or intrathecal (IT) injection. Dosage determined by participant weight.
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Eligibility Criteria

Age Range0 Days to 6 Months
SexALL
Healthy VolunteersNo
Study Sites31

Inclusion Criteria: * Any participant with SMA who received onasemnogene abeparvovec-xioi gene replacement therapy in a Novartis Gene Therapies-sponsored clinical study * Participant/parent/legal guardian willing and able to complete the informed consent process and comply with study procedures and...

Countries:United StatesAustraliaBelgiumCanadaFranceItalyJapanTaiwanUnited KingdomSouth Korea
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Frequently asked questions about Onasemnogene Abeparvovec-xioi

What is Onasemnogene Abeparvovec-xioi used for?

Onasemnogene Abeparvovec-xioi is used for spinal muscular atrophy (SMA), including spinal muscular atrophy type I. It is a gene therapy being developed by Novartis AG for the treatment of SMA, a genetic disorder affecting motor neurons.

What does Onasemnogene Abeparvovec-xioi target?

Onasemnogene Abeparvovec-xioi is a gene therapy that targets the underlying genetic cause of spinal muscular atrophy by delivering a functional copy of the SMN1 gene. It is classified as a -vec/-gene (gene tx) modality.

Who makes Onasemnogene Abeparvovec-xioi?

Onasemnogene Abeparvovec-xioi is developed by Novartis AG, a multinational pharmaceutical company listed on the stock exchange under the ticker NVS.

What phase is Onasemnogene Abeparvovec-xioi in?

Onasemnogene Abeparvovec-xioi is in Phase 3 clinical development. It is an investigational gene therapy and has not been approved by regulatory authorities based on the available information.

What clinical trials is Onasemnogene Abeparvovec-xioi in?

Onasemnogene Abeparvovec-xioi has been studied in several Phase 3 trials, including NCT03306277, NCT03461289, NCT03837184, and NCT04042025. These trials enrolled patients with spinal muscular atrophy type I and other SMA types, with a total enrollment of 87 participants across completed and active studies.

Is Onasemnogene Abeparvovec-xioi the same as Zolgensma?

Onasemnogene Abeparvovec-xioi is the same as Zolgensma, a gene therapy for spinal muscular atrophy. It is also known by the name AVXS-101 in some contexts.