The review of approaches to screening for spinal muscular atrophy in various countries
https://doi.org/10.46563/2686-8997-2025-6-3-160-171
EDN: cjvzdw
Abstract
The purpose of this article is to provide an up-to-date status and outcomes of neonatal screening programs for spinal muscular atrophy (SMA) undertaken in the Russian Federation and other countries, as well as to conduct comparative analysis of these approaches. SMA is one of the most common hereditary neuromuscular disorders that leads to the death in early age. Globally, there is an increasing trend toward incorporating SMA diagnostics into national neonatal screening programs. The key key stages of the SMA diagnostics include the initial identification of high-risk patients using quantitative PCR, followed by confirmatory diagnostics, commonly performed by MLPA. Analyses of global pilot newborn screening projects worldwide have shown the highest incidence of SMA to be 18.71 cases per 100 000 newborns in Japan (Hyōgo Prefecture). In Europe, the greatest incidence was documented in Italy, Germany, and Spain (Valencia). According to the results of expanded neonatal screening conducted in the Russian Federation the SMA prevalence was 9.5 per 100 000 screened newborns. The availability of effective disease-modifying therapies underscores the importance of identifying SMA at the presymptomatic stage to achieve better outcomes in terms of clinically meaningful long-term endpoints. Nowadays there are three disease-modifying drugs that are approved in the Russian Federation: nusinersen, risdiplam, and onasemnogene abeparvovec, which confirms the importance of inclusion neonatal screening for SMA in national neonatal screening program in the Russian Federation.
Contribution:
Voronin S.V. — concept and design, editing;
Mukhortova P.A. — writing the text, editing;
Slabikova A.A. — concept and design, writing the text, editing;
Omelyanovskiy V.V. — editing.
All co-authors — approval of the final version of the manuscript, responsibility for the integrity of all parts of the manuscript.
Funding. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: July 27, 2025
Accepted: August 28, 2025
Published: October 31, 2025
About the Authors
Sergey V. VoroninRussian Federation
PhD (Medicine), chief physician, associate professor, Department of biochemical genetics and hereditary metabolic diseases, Research Centre for Medical Genetics, Moscow, 115522. Russian Federation
e-mail: voroninsvvlad@mail.ru
Polina A. Mukhortova
Russian Federation
Chief specialist, Department of methodological support of health technology assessment, Center for Healthcare Quality Assessment and Control, Moscow, 109028, Russian Federation
e-mail: muhortova@rosmedex.ru
Alexandra A. Slabikova
Russian Federation
Leading specialist, Department of methodological support of health technology assessment, Center for Healthcare Quality Assessment and Control, Moscow, 109028, Russian Federation
e-mail: slabikova@rosmedex.ru
Vitaliy V. Оmelyanovskiy
Russian Federation
DSc (Medicine), professor, general director, Center for Healthcare Quality Assessment and Control, Moscow, 109028, Russian Federation; Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russian Federation
e-mail: vvo@rosmedex.ru
References
1. Hjartarson H.T., Nathorst-Böös K., Sejersen T. Disease modifying therapies for the management of children with spinal muscular atrophy (5q SMA): an update on the emerging evidence. Drug Des. Devel. Ther. 2022; 16: 1865–83. https://doi.org/10.2147/dddt.s214174
2. Clinical recommendations 593_3 «Proximal spinal muscular atrophy 5q»; 2023. (in Russian)
3. Vlodavets D.V., Ganina N.V., Ilina E.S., Kokorina A.A., Kuzenkova L.M., Sapego E.Yu., et al. Retrospective analysis of the natural history of type 1 spinal muscular atrophy in children. Rossiiskii vestnik perinatologii i pediatrii. 2021; 66(4): 64–73. https://doi.org/10.21508/1027-4065-2021-66-4-64-73 https://elibrary.ru/phqhtg (in Russian)
4. Lee B.H., Deng S., Chiriboga C.A., Kay D.M., Irumudomon O., Laureta E., et al. Newborn Screening for Spinal Muscular Atrophy in New York State. Neurology. 2022; 99(14): e1527–37. https://doi.org/10.1212/wnl.0000000000200986
5. Aragon-Gawinska K., Mouraux C., Dangouloff T., Servais L. Spinal muscular atrophy treatment in patients identified by newborn screening – a systematic review. Genes (Basel). 2023; 14(7): 1377. https://doi.org/10.3390/genes14071377
6. Boardman F.K., Sadler C., Young P.J. Newborn genetic screening for spinal muscular atrophy in the UK: The views of the general population. Mol. Genet. Genomic Med. 2018; 6(1): 99-108. https://doi.org/10.1002/mgg3.353
7. Lee T., Tokunaga S., Taniguchi N., Fujino T., Saito M., Shimomura H., et al. Views of the general population on newborn screening for spinal muscular atrophy in Japan. Children (Basel). 2021; 8(8): 694. https://doi.org/10.3390/children8080694
8. Vrščaj E., Dangouloff T., Osredkar D., Servais L. Newborn screening programs for spinal muscular atrophy worldwide in 2023. J. Neuromuscul. Dis. 2024; 11(6): 1180–9. https://doi.org/10.1177/22143602241288095
9. SMA NBS Allians. About us. Available at: https://sma-screening-alliance.org/about-us Accessed July 30, 2025
10. Borovikova A.N., Zhanin I.S. Cases of spinal muscular atrophy identified during extended neonatal screening. Rossiiskii pediatricheskii zhurnal. 2024; 27(S4): 16. https://elibrary.ru/pcarkt (in Russian)
11. Mikhalchuk K., Shchagina O., Chukhrova A., Zabnenkova V., Chausova P., Ryadninskaya N., et al. Pilot program of newborn screening for 5q spinal muscular atrophy in the Russian Federation. Int. J. Neonatal Screen. 2023; 9(2): 29. https://doi.org/10.3390/ijns9020029
12. Kiselev A., Maretina M., Shtykalova S., Al-Hilal H., Maslyanyuk N., Plokhih M., et al. Establishment of a Pilot Newborn Screening Program for Spinal Muscular Atrophy in Saint-Petersburg. Int. J. Neonatal. Screen. 2024; 10(1): 9. https://doi.org/10.3390/ijns10010009
13. Bairova T.A., Astakhova T.A., Belskikh A.V., Belyaeva E.V., Ershova O.A., Sambyalova A.Yu., et al. The first results of extended neonatal screening in the Baikal region. Neonatologiya: novosti, mneniya, obuchenie. 2024; 12(4): 49–60. https://doi.org/10.33029/2308-2402-2024-12-4-49-60 https://elibrary.ru/dnapzl (in Russian)
14. Voronin S.V., Kutsev S.I. Neonatal screening for hereditary diseases in Russia: yesterday, today, and tomorrow. Neonatologiya: novosti, mneniya, obuchenie. 2022; 10(4): 34–9. https://doi.org/10.33029/2308-2402-2022-10-4-34-39 https://elibrary.ru/xjvlyr (in Russian)
15. Voronin S.V., Zakharova E.Yu., Baydakova G.V., Marakhonov A.V., Shchagina O.A., Ryzhkova O.P., et al. Advanced neonatal screening for hereditary diseases in Russia: first results and future prospects. Pediatriya. Zhurnal im. G.N. Speranskogo. 2024; 103(1): 16–29. https://doi.org/10.24110/0031-403X-2024-103-1-16-29 https://elibrary.ru/txvobf (in Russian)
16. SMA NBS Alliance. Status Map. Available at: https://sma-screening-alliance.org/map Accessed July 30, 2025
17. Hegedűs K., Lénárt I., Xue A., Monostori P.B., Baráth Á., Mikos B., et al. Results of the Hungarian Newborn Screening Pilot Program for Spinal Muscular Atrophy. Int. J. Neonatal. Screen. 2025; 11(2): 29. https://doi.org/10.3390/ijns11020029
18. Boemer F., Caberg J.H., Beckers P., Dideberg V., di Fiore S., Bours V., et al. Three years pilot of spinal muscular atrophy newborn screening turned into official program in Southern Belgium. Sci. Rep. 2021; 11(1): 19922. https://doi.org/10.1038/s41598-021-99496-2
19. Berzal-Serrano A., García-Bohórquez B., Aller E., Jaijo T., Pitarch-Castellano I., Rausell D., et al. Outcomes of a pilot newborn screening program for spinal muscular atrophy in the Valencian community. Int. J. Neonatal. Screen. 2025; 11(1): 7. https://doi.org/10.3390/ijns11010007
20. Gagliardi D., Canzio E., Orsini P., Conti P., Sinisi V., Maggiore C., et al. Early spinal muscular atrophy treatment following newborn screening: A 20‐month review of the first Italian regional experience. Ann. Clin. Transl. Neurol. 2024; 11(5): 1090–6. https://doi.org/10.1002/acn3.52018
21. Vill K., Kölbel H., Schwartz O., Blaschek A., Olgemöller B., Harms E., et al. One year of newborn screening for SMA – results of a German pilot project. In: Journal of Neuromuscular Diseases. London: SAGE Publications; 2019.
22. Vill K., Schwartz O., Blaschek A., Gläser D., Nennstiel U., Wirth B., et al. Newborn screening for spinal muscular atrophy in Germany: clinical results after 2 years. Orphanet J. Rare Dis. 2021; 16(1): 153. https://doi.org/10.1186/s13023-021-01783-8
23. Abiusi E., Vaisfeld A., Fiori S., Novelli A., Spartano S., Faggiano M.V., et al. Experience of a 2-year spinal muscular atrophy NBS pilot study in Italy: towards specific guidelines and standard operating procedures for the molecular diagnosis. J. Med. Genet. 2023; 60(7): 697–705. https://doi.org/10.1136/jmg-2022-108873
24. Cure SMA. Newborn Screening for SMA. Available at: https://curesma.org/newborn-screening-for-sma/ Accessed July 30, 2025
25. Hale K., Ojodu J., Singh S. Landscape of spinal muscular atrophy newborn screening in the United States: 2018–2021. Int. J. Neonatal Screen. 2021; 7(3): 33. https://doi.org/10.3390/ijns7030033
26. Zaidman C.M., Crockett C.D., Wedge E., Tabatabai G., Goedeker N. Newborn screening for spinal muscular atrophy: variations in practice and early management of infants with spinal muscular atrophy in the United States. Int. J. Neonatal Screen. 2024; 10(3): 58. https://doi.org/10.3390/ijns10030058
27. Wong K.N., McIntyre M., Cook S., Hart K., Wilson A., Moldt S., et al. A five-year review of newborn screening for spinal muscular atrophy in the State of Utah: lessons learned. Int. J. Neonatal Screen. 2024; 10(3): 54. https://doi.org/10.3390/ijns10030054
28. Baker M.W., Mochal S.T., Dawe S.J., Wiberley-Bradford A.E., Cogley M.F., Zeitler B.R., et al. Newborn screening for spinal muscular atrophy: The Wisconsin first year experience. Neuromuscul. Disord. 2022; 32(2): 135–41. https://doi.org/10.1016/j.nmd.2021.07.398
29. Elkins K., Wittenauer A., Hagar A.F., Logan R., Sekul E., Xiang Y., et al. Georgia state spinal muscular atrophy newborn screening experience: Screening assay performance and early clinical outcomes. Am. J. Med. Genet. C Semin. Med. Genet. 2022; 190(2): 187–96. https://doi.org/10.1002/ajmg.c.32003
30. Matteson J., Wu C.H., Mathur D., Tang H., Sciortino S., Feuchtbaum L., et al. California’s experience with SMA newborn screening: A successful path to early intervention. J. Neuromuscul. Dis. 2022; 9(6): 777–85. https://doi.org/10.3233/jnd-221561
31. Kraszewski J.N., Kay D.M., Stevens C.F., Koval C., Haser B., Ortiz V., et al. Pilot study of population-based newborn screening for spinal muscular atrophy in New York state. Genet. Med. 2018; 20(6): 608–13. https://doi.org/10.1038/gim.2017.152
32. Kay D.M., Stevens C.F., Parker A., Saavedra-Matiz C.A., Sack V., Chung W.K., et al. Implementation of population-based newborn screening reveals low incidence of spinal muscular atrophy. Genet. Med. 2020; 22(8): 1296–302. https://doi.org/10.1038/s41436-020-0824-3
33. Hale J.E., Darras B.T., Swoboda K.J., Estrella E., Chen J.Y.H., Abbott M.A., et al. Massachusetts’ findings from statewide newborn screening for spinal muscular atrophy. Int. J. Neonatal Screen. 2021; 7(2): 26. https://doi.org/10.3390/ijns7020026
34. Belter L., Taylor J.L., Jorgensen E., Glascock J., Whitmire S.M., Tingey J.J., et al. Newborn screening and birth prevalence for spinal muscular atrophy in the US. JAMA Pediatr. 2024; 178(9): 946–9. https://doi.org/10.1001/jamapediatrics.2024.1911
35. Groulx-Boivin E., Osman H., Chakraborty P., Lintern S., Oskoui M., Selby K., et al. Variability in newborn screening across Canada: spinal muscular atrophy and beyond. Can. J. Neurol. Sci. 2024; 51(2): 203–9. https://doi.org/10.1017/cjn.2023.34
36. McMillan H.J., Kernohan K.D., Yeh E., Amburgey K., Boyd J., Campbell C., et al. Newborn screening for spinal muscular atrophy: Ontario testing and follow-up recommendations. Can. J. Neurol. Sci. 2021; 48(4): 504–11. https://doi.org/10.1017/cjn.2020.229
37. Niri F., Nicholls J., Baptista Wyatt K., Walker C., Price T., Kelln R., et al. Alberta spinal muscular atrophy newborn screening – results from year 1 pilot project. Int. J. Neonatal Screen. 2023; 9(3): 42. https://doi.org/10.3390/ijns9030042
38. Kernohan K.D., McMillan H.J., Yeh E., Lacaria M., Kowalski M., Campbell C., et al. Ontario newborn screening for spinal muscular atrophy: the first year. Can. J. Neurol. Sci. 2022; 49(6): 821–3. https://doi.org/10.1017/cjn.2021.231
39. Romanelli Tavares V.L., Mendonça R.H., Toledo M.S., Hadachi S.M., Grindler C.M., Zanoteli E., et al. Integrated approaches and practical recommendations in patient care identified with 5q spinal muscular atrophy through newborn screening. Genes (Basel). 2024; 15(7): 858. https://doi.org/10.3390/genes15070858
40. Oliveira Netto A.B., Brusius-Facchin A.C., Lemos J.F., Pasetto F.B., Brasil C.S., Trapp F.B., et al. Neonatal screening for spinal muscular atrophy: A pilot study in Brazil. Genet. Mol. Biol. 2023; 46(3 Suppl. 1): e20230126. https://doi.org/10.1590/1678-4685-gmb-2023-0126
41. Chien Y.H., Chiang S.C., Weng W.C., Lee N.C., Lin C.J., Hsieh W.S., et al. Presymptomatic diagnosis of spinal muscular atrophy through newborn screening. J. Pediatr. 2017; 190: 124–9.e1. https://doi.org/10.1016/j.jpeds.2017.06.042
42. Weng W.C., Hsu Y.K., Chang F.M., Lin C.Y., Hwu W.L., Lee W.T., et al. CMAP changes upon symptom onset and during treatment in spinal muscular atrophy patients: lessons learned from newborn screening. Genet. Med. 2021; 23(2): 415–20. https://doi.org/10.1038/s41436-020-00987-w
43. Wang C.H., Hsu T.R., Liu M.Y., Wang L.Y., Chou I.J., Lee W.T., et al. Newborn screening facilitates early theranostics and improved spinal muscular atrophy outcome: five-year real-world evidence from Taiwan. Orphanet J. Rare Dis. 2025; 20(1): 197. https://doi.org/10.1186/s13023-025-03697-1
44. Sonehara S., Bo R., Nambu Y., Iketani K., Lee T., Shimomura H., et al. Newborn screening for spinal muscular atrophy: a 2.5-year experience in Hyogo prefecture, Japan. Genes (Basel). 2023; 14(12): 2211. https://doi.org/10.3390/genes14122211
45. Noguchi Y., Bo R., Nishio H., Matsumoto H., Matsui K., Yano Y., et al. PCR-based screening of spinal muscular atrophy for newborn infants in Hyogo prefecture, Japan. Genes (Basel). 2022; 13(11): 2110. https://doi.org/10.3390/genes13112110
46. Kimizu T., Nozaki M., Okada Y., Sawada A., Morisaki M., Fujita H., et al. Multiplex real-time PCR-based newborn screening for severe primary immunodeficiency and spinal muscular atrophy in Osaka, Japan: оur results after 3 years. Genes (Basel). 2024; 15(3): 314. https://doi.org/10.3390/genes15030314
47. Kimizu T., Ida S., Oki K., Shima M., Nishimoto S., Nakajima K., et al. Newborn screening for spinal muscular atrophy in Osaka-challenges in a Japanese pilot study. Brain Dev. 2023; 45(7): 363–71. https://doi.org/10.1016/j.braindev.2023.03.004
48. Sawada T., Kido J., Sugawara K., Yoshida S., Ozasa S., Nomura K., et al. Newborn screening for spinal muscular atrophy in Japan: оne year of experience. Mol. Genet. Metab. Rep. 2022; 32: 100908. https://doi.org/10.1016/j.ymgmr.2022.100908
49. D’Silva A.M., Kariyawasam D.S.T., Best S., Wiley V., Farrar M.A. Integrating newborn screening for spinal muscular atrophy into health care systems: an Australian pilot programme. Dev. Med. Child Neurol. 2022; 64(5): 625–32. https://doi.org/10.1111/dmcn.15117
50. Kariyawasam D.S.T., Russell J.S., Wiley V., Alexander I.E., Farrar M.A. The implementation of newborn screening for spinal muscular atrophy: the Australian experience. Genet. Med. 2020; 22(3): 557–65. https://doi.org/10.1038/s41436-019-0673-0
51. Efimova I.Y., Zinchenko R.A., Marakhonov A.V., Balinova N.V., Mikhalchuk K.A., Shchagina O.A., et al. Epidemiology of spinal muscular atrophy based on the results of a large-scale pilot project on 202,908 newborns. Pediatr. Neurol. 2024; 156: 147–54. https://doi.org/10.1016/j.pediatrneurol.2024.04.015
52. Šimić D., Šarić A., Škaričić A., Lehman I., Bunoza B., Rako I., et al. One-year pilot study results of newborn screening for spinal muscular atrophy in the Republic of Croatia. Int. J. Neonatal Screen. 2024; 10(3): 50. https://doi.org/10.3390/ijns10030050
53. Screening programmes: a short guide. Increase effectiveness, maximize benefits and minimize harm. Copenhagen: WHO Regional Office for Europe; 2020.
54. Cooper K., Nalbant G., Sutton A., Harnan S., Thokala P., Chilcott J., et al. Systematic review of presymptomatic treatment for spinal muscular atrophy. Int. J. Neonatal Screen. 2024; 10(3): 56. https://doi.org/10.3390/ijns10030056
55. Müller-Felber W., Blaschek A., Schwartz O., Gläser D., Nennstiel U., Brockow I., et al. Newbornscreening SMA – from pilot project to nationwide screening in Germany. J. Neuromuscul. Dis. 2023; 10(1): 55–65. https://doi.org/10.3233/jnd-221577
56. The «Circle of Kindness» Foundation. Expanded neonatal screening in 2023 helped to identify and provide for 100 newborns with SMA. Available at: https://фондкругдобра.рф/расширенный-неонатальный-скрининг-в-2023/ (in Russian) Accessed July 30, 2025
Review
For citations:
Voronin S.V., Mukhortova P.A., Slabikova A.A., Оmelyanovskiy V.V. The review of approaches to screening for spinal muscular atrophy in various countries. L.O. Badalyan Neurological Journal. 2025;6(3):160-171. (In Russ.) https://doi.org/10.46563/2686-8997-2025-6-3-160-171. EDN: cjvzdw
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