SMA: a new treatment targeting muscle has just been approved for marketing in the US

On 11 September 2026, the US Food and Drug Administration (FDA) granted marketing authorisation for the anti-myostatin drug Isembyld (or apitegromab) for the treatment of proximal spinal muscular atrophy (SMA).

As the first treatment to act directly on muscle in SMA, it is indicated for patients aged over two years who are already receiving treatment targeting the SMN2 gene (Spinraza or Evrysdi), administered intravenously at a dose of 10 mg/kg every four weeks.

  • Results from the Phase III SAPPHIRE trial show that it provides an additional, albeit modest, motor benefit (+1.8 points on the HFMSE) when used in combination with Spinraza or Evrysdi, compared with the placebo group.
  • The treatment was well tolerated, and 98 per cent of participants in the SAPPHIRE trial chose to enter the open-label ONYX extension phase, which is assessing its long-term efficacy.