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exagamglogene autotemcel (Casgevy)
Indications:
- gene-editing for treatment of patients with sickle cell disease >= 12 years
Procedure:
- myeloablative conditioning, bone marrow ablation (high-dose chemotherapy)
- single infusion of modified hematopoietic stem cells
Adverse effects:
- leukopenia, thromocytopenia, febrile neutropenia
- stomatitis, nausea/vomiting, abdominal pain
- headache, pruritus
Mechanism of action:
- hematopoietic stem cells are modified by genome editing using CRISPR/Cas9
- CRISPR/Cas9 is directed to cut DNA in targeted areas, enabling gene-editing edit (remove, add, or replace) DNA where it was cut
- modified hematopoietic stem cells are transplanted back into the patient
- the stem cells engraft within the bone marrow & increase the production of hemoglobin F presumptively by silencing production of hemoglobin S
General
CRISPR; clustered regularly interspaced short palindromic repeats
References
- AMA Morning Rounds. Dec 11, 2023
American Medical Association
- Lou N
Milestone Gene Therapies for Sickle Cell Disease Greenlit by FDA.
Casgevy and Lyfgenia approved for one-time treatment of sickle cell disease.
MedPage Today December 8, 2023
https://www.medpagetoday.com/hematologyoncology/hematology/107751
- Brooks PJ, Clay JP
A Closer Look at the Approval of CRISPR/Cas9 Gene Therapy for Sickle Cell Disease.
This landmark event brings up broader considerations and implications for other
diseases.
MedPage Today. Dec 11, 2023
https://www.medpagetoday.com/opinion/second-opinions/107793
- FDA News Release, Dec 8, 2023
FDA Approves First Gene Therapies to Treat Patients with Sickle Cell Disease.
https://www.fda.gov/news-events/press-announcements/fda-approves-first-gene-therapies-treat-patients-sickle-cell-disease