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Spinal Muscular AtrophyJanuary 2022

What the SUNFISH Trial Found — Risdiplam for Older Children and Adults With SMA

SUNFISH tested risdiplam, a daily liquid taken by mouth, in 180 people ages 2-25 with type 2 or non-walking type 3 spinal muscular atrophy. After 12 months, motor function improved on risdiplam compared with the inactive liquid.

What the trial was testing

The SUNFISH enrolled 231 patients with spinal muscular atrophy. The study was sponsored by Hoffmann-La Roche and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was initial testing (phase 2). Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

Motor function improved 1.55 points on risdiplam vs. inactive comparison.

The Lancet Neurology · 2022 · NCT02908685

These findings — that in motor function on risdiplam vs. inactive comparison over 12 months — were published in the The Lancet Neurology and represent the headline result of the study.

Researchers tracked outcomes across 231 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with spinal muscular atrophy, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Risdiplam (Evrysdi) is FDA-approved and available now for SMA in people of any age. It is taken once daily by mouth and is often preferred when spinal injections (nusinersen) or IV gene therapy (Zolgensma) are difficult. Ask a neurologist about which SMA treatment fits best.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.