Kernicterus affects mainly the basal ganglia, and its effects can spread to the hippocampus, geniculate nuclei, and cranial nerve nuclei. Symptoms of kernicterus include athetoid cerebral palsy and in severe cases, may lead to death of the patient. Most cases of kernicterus develop in infants following early hospital discharge from phototherapy. == References ==
History
Lumasiran was evaluated by the U.S. Food and Drug Administration (FDA) in two studies of participants with PH1: a randomized, placebo-controlled trial in participants six years and older and an open-label study in participants younger than six years (NCT03681184 and NCT03905694). Participants ranged in age from four months to 61 years at the first dose. In the first study, 26 participants received a monthly injection of lumasiran followed by a maintenance dose every three months; 13 participants received placebo injections. Neither the patients nor the healthcare providers knew which treatment was being given until after the trial was completed. The primary endpoint was the amount of oxalate measured in the urine over 24 hours. In the lumasiran group, participants had, on average, a 65% reduction of oxalate in the urine, compared to an average 12% reduction in the placebo group. By the sixth month of the study, 52% of participants treated with lumasiran reached a normal 24-hour urinary oxalate level; no participants treated with the placebo did. In the second study, 16 participants younger than six years all received lumasiran. Using another measure of oxalate in the urine, the study showed, on average, a 71% decrease in urinary oxalate by the sixth month of the study. The trials were conducted at 25 centers in the United States, Europe, and the Middle East.The FDA granted the application for lumasiran orphan drug and breakthrough therapy designations. In addition, the manufacturer received a rare pediatric disease priority review voucher.