Journal Article

DZNE-2025-00166

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png SOD1 gene screening in ALS - frequency of mutations, patients' attitudes to genetic information and transition to tofersen treatment in a multi-center program.

Meyer, T. ; Schumann, P. ; Grehl, T. ; Weyen, U. ; Petri, S. ; Rödiger, A. ; Steinbach, R. ; Grosskreutz, J. ; Bernsen, S.DZNE* ; Weydt, P.DZNE* ; Wolf, J. ; Günther, R.DZNE* ; Vidovic, M. ; Baum, P. ; Metelmann, M. ; Weishaupt, J. H. ; Streubel, B. ; Kasper, D. C. ; Koc, Y. ; Kettemann, D. ; Norden, J. ; Schmitt, P. ; Walter, B. ; Münch, C. ; Spittel, S. ; Maier, A. ; Körtvelyessy, P.Extern*

2025
Taylor Francis Group Abingdon

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Please use a persistent id in citations: doi:10.1080/21678421.2024.2401131

Abstract: To report the frequency of pathogenic SOD1 gene variants in a screening program in amyotrophic lateral sclerosis (ALS), and the clinical practice of transition to an expanded access program (EAP) of tofersen treatment.From October 2021 to February 2024, at 11 ALS centers in Germany genetic testing for SOD1, FUS, TARDBP, and C9orf72 was performed. Patients were offered to opt for notification either about all genetic variants or SOD1 variants relevant for tofersen therapy. The transition to the EAP with tofersen was assessed.1935 patients were screened (94.7% sporadic ALS). 48.8% (n = 928) opted for notification of treatment-relevant information. Genetic variants were found as follows: SOD1 (likely) pathogenic variants (class 4/5) 1.8% (n = 34), variants of unknown significance (class 3) 0.8% (n = 16), FUS (class 4/5) 0.9% (n = 17), TARDBP (class 4/5) 1.3% (n = 25), C9orf72 hexanucleotide repeat expansion 7.0% (n = 135). In SOD1-ALS (encompassing class 3-5 variants, n = 50), 68.0% (n = 34) reported a negative family history. 74.0% (n = 37) of SOD1-ALS patients - which represent 1.9% of all participants of the screening program - were transitioned to tofersen. Median duration from start of genetic testing to treatment was 94 days (57 to 295 days). Eight patients declined treatment whereas five individuals died before initiation of therapy.The finding of SOD1 variants in patients with a negative family history underscores the need for a broad genetic screening in ALS. In SOD1-ALS, the treatment option with tofersen was mostly utilized. The wide range in the transition time to tofersen calls for a SOD1-ALS management program.

Keyword(s): Humans (MeSH) ; Amyotrophic Lateral Sclerosis: genetics (MeSH) ; Amyotrophic Lateral Sclerosis: drug therapy (MeSH) ; Amyotrophic Lateral Sclerosis: diagnosis (MeSH) ; Superoxide Dismutase-1: genetics (MeSH) ; Male (MeSH) ; Female (MeSH) ; Genetic Testing: methods (MeSH) ; Middle Aged (MeSH) ; Mutation: genetics (MeSH) ; Aged (MeSH) ; Adult (MeSH) ; C9orf72 Protein: genetics (MeSH) ; Germany (MeSH) ; RNA-Binding Protein FUS: genetics (MeSH) ; DNA-Binding Proteins (MeSH) ; Amyotrophic lateral sclerosis ; SOD1 gene ; screening ; tofersen ; transition ; Superoxide Dismutase-1 ; SOD1 protein, human ; C9orf72 Protein ; TARDBP protein, human ; C9orf72 protein, human ; RNA-Binding Protein FUS ; FUS protein, human ; DNA-Binding Proteins

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Contributing Institute(s):

1. Clinical Research Coordination (Clinical Research (Bonn))
2. Translational Parkinson Research (AG Falkenburger)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2025

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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