Overview

Zolgensma is a gene therapy medicine for treating spinal muscular atrophy, a serious condition of the nerves that causes muscle wasting and weakness.

It is intended for patients with inherited mutations affecting a gene known as SMN1, who have either been diagnosed with SMA type 1 (the most severe type) or have up to 3 copies of another gene known as SMN2.

Spinal muscular atrophy is rare, and Zolgensma was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 19 June 2015. Further information on the orphan designation can be found here: ema.europa.eu/medicines/human/orphan-designations/eu3151509.

Zolgensma contains the active substance onasemnogene abeparvovec.

Zolgensma is given once as an infusion (drip) into a vein lasting about 1 hour. The infusion should take place in a clinic or hospital under the supervision of a doctor experienced in managing spinal muscular atrophy.

Before and after receiving the infusion, the patient will have a number of tests, including liver and blood tests, and will be given corticosteroid medicines to reduce the risk of side effects. The medicine can only be obtained with a prescription. For more information about using Zolgensma, see the package leaflet or contact your doctor or pharmacist.

Patients with spinal muscular atrophy have a defect in a gene known as SMN1, which the body needs to make a protein essential for the normal functioning of nerves that control muscle movements. The active substance in Zolgensma, onasemnogene abeparvovec, contains a functional copy of this gene. When injected, it passes into the nerves from where it provides the correct gene to make enough of the protein and thereby restore nerve function.

A main study showed that Zolgensma reduces the need for artificial ventilation in babies with spinal muscular atrophy. In this study, 20 out of the 22 babies given Zolgensma were alive and breathing without a permanent ventilator after 14 months, when normally only a quarter of untreated patients would survive without needing a ventilator.

The study also showed that Zolgensma can help babies sit unaided for at least 30 seconds. 14 out of the 22 babies given Zolgensma were able to do so after 18 months, a milestone that is never achieved in untreated babies with severe forms of the disease.

The most common side effects with Zolgensma are raised liver enzymes, injury to the liver (hepatotoxicity), low levels of blood platelets (thrombocytopenia), raised levels of troponin (a measure which indicates damage to the heart muscle), fever and vomiting.

For the full list of restrictions and side effects of Zolgensma, see the package leaflet.

The main study of Zolgensma showed that a one-time infusion can improve survival in these patients and reduce the need for a permanent ventilator to breathe. It can also help them reach development milestones. As for its safety, the side effects of Zolgensma are considered manageable; the most common side effect in the study, raised liver enzymes, required treatment with a steroid. The European Medicines Agency therefore decided that Zolgensma’s benefits are greater than its risks and it can be authorised for use in the EU.

Zolgensma was originally given ‘conditional authorisation’ because there was more evidence to come about the medicine. As the company has supplied the additional information necessary, the authorisation has been switched from conditional to full authorisation.

The company that markets Zolgensma will provide educational materials to caregivers with information on how to use the medicine safely, the risks associated with the medicine and how to identify and report side effects. It will also conduct a study of the medicine’s safety and effectiveness in the long-term.

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Zolgensma have also been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Zolgensma are continuously monitored. Side effects reported with Zolgensma are carefully evaluated and any necessary actions taken to protect patients.

Zolgensma received a conditional marketing authorisation valid throughout the EU on 18 May 2020. This was switched to a full marketing authorisation on 17 May 2022.

Further information on Zolgensma can be found on the Agency’s website: ema.europa.eu/medicines/human/EPAR/zolgensma

This overview was last updated in 08-2022.

Zolgensma : EPAR - Medicine overview

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Zolgensma : EPAR - Risk-management-plan summary

Product information

Zolgensma : EPAR - Product information

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Latest procedure affecting product information: IB/0046

06/12/2023

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This medicine’s product information is available in all official EU languages.
Select 'available languages' to access the language you need.

Product information documents contain:

  • summary of product characteristics (annex I);
  • manufacturing authorisation holder responsible for batch release (annex IIA);
  • conditions of the marketing authorisation (annex IIB);
  • labelling (annex IIIA);
  • package leaflet (annex IIIB).

Zolgensma : EPAR - All authorised presentations

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Product details

Name of medicine
Zolgensma
Active substance
onasemnogene abeparvovec
International non-proprietary name (INN) or common name
onasemnogene abeparvovec
Therapeutic area (MeSH)
Muscular Atrophy, Spinal
Anatomical therapeutic chemical (ATC) code
M09AX09

Pharmacotherapeutic group

Other drugs for disorders of the musculo-skeletal system

Therapeutic indication

Zolgensma is indicated for the treatment of:

  • patients with 5q spinal muscular atrophy (SMA) with a bi-allelic mutation in the SMN1 gene and a clinical diagnosis of SMA Type 1, or
  • patients with 5q SMA with a bi-allelic mutation in the SMN1 gene and up to 3 copies of the SMN2 gene.

Authorisation details

EMA product number
EMEA/H/C/004750

Additional monitoring

This medicine is under additional monitoring, meaning that it is monitored even more intensively than other medicines. For more information, see Medicines under additional monitoring.

Conditional approval

This medicine received a conditional marketing authorisation. This was granted in the interest of public health because the medicine addresses an unmet medical need and the benefit of immediate availability outweighs the risk from less comprehensive data than normally required. For more information, see Conditional marketing authorisation.

Orphan

This medicine was designated an orphan medicine. This means that it was developed for use against a rare, life-threatening or chronically debilitating condition or, for economic reasons, it would be unlikely to have been developed without incentives. For more information, see Orphan designation.

Marketing authorisation holder
Novartis Europharm Limited 

Vista Building
Elm Park
Merrion Road
Dublin 4
D04 A9N6 
Ireland

Opinion adopted
26/03/2020
Marketing authorisation issued
18/05/2020
Revision
14

Assessment history

Zolgensma : EPAR - Procedural steps taken and scientific information after authorisation

Zolgensma-H-C-004750-P46-018 : EPAR - Assessment Report

Zolgensma : Orphan maintenance assessment report (initial authorisation)

Zolgensma : EPAR - Public assessment report

CHMP summary of positive opinion for Zolgensma

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