Henry Kaminski, MD, Department of Neurology, and Linda Kusner, PhD, Department of Pharmacology & Physiology at George Washington University, discuss predicting response outcomes with proteomic and machine learning analyses in treating patients with myasthenia gravis (MG).

MG is a chronic autoimmune neuromuscular disease characterized by weakness of the skeletal muscles. It mostly develops in adults but children can also develop this rare condition. Common symptoms include weakness of the muscles that control the eye and eyelid, facial expressions, chewing, talking, and swallowing. The condition results from a defect in the transmission of nerve impulses to muscles usually due to the presence of antibodies against the acetylcholine receptor. The exact reason this occurs is not known.

A study published in Springer Nature analyzed serum proteomes collected at baseline from participants in a phase 3 randomized trial comparing thymectomy plus prednisone versus prednisone alone, along with matched controls using liquid chromatography–mass spectrometry.

Due to the variable treatment responses present in patients with MG, there is a need for biomarkers to guide therapeutic decision making. Proteomic profiling, coupled with machine learning, was utilized to offer a hypothesis-free approach to identify multi-protein signatures associated with treatment response.

Results showed that baseline serum proteomes distinguished MG from controls, with pathway enrichment implicating complement activation, immunoglobulin production, and T-cell receptor signaling. Distinct protein panels predicted 6-month clinical improvement within each treatment arm. In the thymectomy-plus-prednisone group, models captured non-linear relationships of predictive proteins in contrast with the predominant additive patterns observed in the prednisone-alone group. Predictive proteins were enriched for T-cell signaling and leukocyte trafficking functions, providing insight into treatment-specific biology.

While Drs. Kaminski and Kusner explain that there is still much work to be done, this method captured core disease characteristics of MG and predicted short-term clinical response in a treatment-specific manner. These findings could enable biomarker-guided selection of treatment, refine risk stratification, and furnish mechanistic readouts for future MG trials and clinical care.

To learn more about gMG and other rare neurological conditions, visit https://checkrare.com/diseases/neurology-nervous-system-diseases/

CHAPTERS
Introduction 00:00
What This Study Was Hoping To Answer 00:59
Proteomic And Machine Learning Outcomes 2:19
Different Patient Responses to Treatments 4:28
Implementing This Approach 7:17
What This Could Mean for Patients 8:53
Take Home Message 11:18

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Eric Scheeff, PhD, Chief Scientific Officer at iDefine, discusses the treatment development of RNA amplifiers in patients with Kleefstra syndrome.

Kleefstra syndrome is a rare disorder characterized by developmental delay and intellectual disability, severely limited or absent speech, distinctive facial features, and hypotonia. People with Kleefstra syndrome may also have structural brain abnormalities, congenital heart defects, genitourinary abnormalities, seizures, and a tendency to develop severe respiratory infections. During childhood they may exhibit features of autism or related developmental disorders affecting communication and social interaction. In adolescence, they may develop a general loss of interest and enthusiasm or unresponsiveness. The condition is a haploinsufficiency caused by mutations in the EHMT1 gene or the deletion of a specific region of chromosome 9 that includes EHMT1.

Current treatment options are supportive, such as speech therapy and seizure medications, with no approved treatments targeting the underlying cause of disease. Dr. Scheef explains that these options are inadequately addressing the severity of disease that most patients experience.

iDefine is currently collaborating with Dr. Jeff Coller’s lab at Johns Hopkins University, where RNA amplifiers are being investigated to increase the effectiveness of the one EHMT1 gene present in patients with Kleefstra syndrome. The goal with this technology is to expand into other haploinsufficiencies using a similar mechanism.

To other patient organizations looking to develop their own treatment, Dr. Scheef recommends starting with the underlying biology of disease and building a scientific advisory board. Once that foundation is in place, set the goal of a clinical trial and work backwards to determine what steps need to be taken.

To learn more about potentially partnering with IDefine email [email protected]

For more information on rare genetic conditions, visit https://checkrare.com/diseases/congenital-and-genetic-conditions/

Kleefstra Syndrome Overview 00:11
Current Treatment Options 1:29
Diagnostic Journey 2:00
Targeted Therapy Development 4:20
Application in Other Indications 5:41
Advice on Drug Development for Advocacy Groups 7:52
Take Home Message 9:13

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FDA approval is a major milestone, but for patients with rare diseases, it is only the beginning. In this episode of The CheckRare Brief, we look at two new rare disease approvals, ongoing drug supply problems affecting patients, and a major acquisition that illustrates how rare disease therapies move from small biotech companies into the hands of larger pharmaceutical companies.

The US Food and Drug Administration (FDA) granted accelerated approval to Ultragenyx’s Genglycos for the treatment of GSD1a. GSD1a is a rare metabolic disorder, caused by mutations in the G6PC gene, that impairs glucose production. The dietary standard of care, uncooked cornstarch every three to six hours, nocturnal feeds, and strict exclusion of fructose, galactose, and sucrose, has sustained life but cannot correct the underlying enzymatic deficiency and is a major burden on patients and caregivers. However, the gene therapy showed a reduction in cornstarch consumption by 30%. Ultragenyx also received a Priority Review Voucher alongside the drug’s approval.

The FDA also approved Pasatru to treat patients with FOP, a disorder in which skeletal muscle and connective tissue are gradually ossified. The approval is based on safety and efficacy data from the phase 3 OPTIMA clinical trial in which Pasatru was found to reduce FOP flare ups by 90%. This marks the second FDA approved treatment for the indication, giving patients and physicians options in their management.

Sanofi is currently facing supply chain issues, including in their treatments for Pompe disease and hemophilia. An FDA inspection in January highlighted several quality control concerns at a manufacturing plant in Ireland, and in June the FDA followed up with a letter stating that these concerns had not been addressed. While the plant is still open, they are making significant changes to the site to be compliant. Sanofi is doing its best to get therapies back to patients, but the patients are very frustrated about the lack of transparency and the lack of a back up manufacturing plant.

Finally, the pharmaceutical company Biomarin bought Alesta, a small biotech company that is developing a treatment for hypophosphatasia. Hypophosphatasia is a rare metabolic disorder that leads to poor mineralization in teeth and bones. Currently, Stensiz is available as an enzyme replacement therapy but there is always a need for patients to have treatment options. The drug Biomarin just bought, ALE1, is in a phase 1/2 study. Details on the trial are currently unknown, but it would appear the data was compelling enough for Biomarin to buy it. This partnership between small biotech and big pharma is seen often in rare diseases. Small biotechs can be very good at discovering and developing a promising drug, but eventually capital, regulatory expertise, manufacturing, and commercial infrastructure are necessary to get these treatments to patients.

References
FDA approves Ultragenyx drug for GSD1a
https://www.fda.gov/news-events/press-announcements/fda-approves-first-therapy-patients-aged-8-years-and-older-glycogen-storage-disease-type-ia


FDA approves Regeneron drug for FOP
https://www.globenewswire.com/news-release/2026/08/19/3347919/0/en/pasatru-garetosmab-grts-first-and-only-fda-approved-treatment-demonstrating-reduction-in-new-heterotopic-ossification-ho-lesions-and-clinician-assessed-flare-ups-in-a-placebo-contr.html

Sanofi drug supply shortage
https://www.sanofi.com/en/our-science/therapeutic-areas/rare-diseases/supply-update

BioMarin buys third rare disease company in a year
https://www.prnewswire.com/news-releases/biomarin-to-acquire-alesta-therapeutics-to-gain-ale1-a-potential-first-oral-therapy-for-hypophosphatasia-adding-an-important-clinical-program-to-biomarins-pipeline-302854068.html

FDA Extends Review of Capricor’s Deramiocel for DMD
https://www.capricor.com/investors/news-events/press-releases/detail/354/capricor-therapeutics-announces-extension-of-pdufa-target

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In the first episode of the Rare Endocrine Exchange, Margarita Ochoa-Maya, MD, discusses when further diagnostic testing should be done. Learn more about our new podcast and why this conversation matters at https://checkrare.com/multimedia/rare-endocrine-exchange/ or wherever you get your podcasts.

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On this week’s episode of The CheckRare Brief, we discuss FDA’s approval of Zenbexus (iberdomide) to treat patients with multiple myeloma, the complete response letter issued to ITM-11 to treat patients with neuroendocrine tumors, and safety concerns about VYKAT XR for Prader-Willi syndrome (PWS).
The US Food and Drug Administration (FDA) granted accelerated approval to Bristol Myers Squibb’s iberdomide to treat patients with relapsed or refractory multiple myeloma on August 13, 2026. This treatment is a cereblon E3 ligase modulator (CELMoD), a new therapeutic class of drug. The approval is largely based on results from the EXCALIBER-RRMM clinical trial (NCT04975997), a two-stage, randomized, multicenter, open-label trial in adults with relapsed or refractory MM who had previously received one or two prior lines of therapy. Additionally, another new trend is the outcome measure of minimal residual disease, a departure from more traditional measures such as overall survival or progression free survival.

In other regulatory news, the FDA gave ITM a complete response letter (CRL) for ITM-11, a radioisotope (177-lutetium) attached to a peptide (edotreotide) that emits beta radiation towards targeted tumors, for neuroendocrine tumors. A phase 3 clinical trial showed the treatment to be significantly better than the control group, with a progression free survival of 24 months in the ITM-11 group versus 14 months in the control group. It appears that the FDA's concern wasn't the drug efficacy but about the manufacturing process. While it is a setback, it does not necessarily mean the drug has been rejected permanently. The company can address the FDA's concerns and resubmit the application.

Finally, the Foundation for Prader-Willi Research are voicing concerns about VYKAT XR (diazoxide choline), a treatment approved in 2025 for children with Prader-Willi syndrome to address dysphagia. The main concern has to do with excessive fluid retention occurring in some patients that can lead to other serious adverse events, including cardiac and breathing concerns. The drug was approved last year to treat children with Prader-Willi syndrome to better control their hunger. These concerns highlight the importance of making physicians aware of the drug’s safety and efficacy in a real-world setting following drug approval. 

Sources
FDA Grants Accelerated Approval For Multiple Myeloma Drug
https://www.businesswire.com/news/home/20260811027471/en/U.S.-FDA-Grants-Accelerated-Approval-to-Bristol-Myers-Squibbs-First-CELMoD-Therapy-ZENBEXUS-in-Combination-with-Daratumumab-and-Hyaluronidase-fihj-and-Dexamethasone-ZDd-for-Patients-with-Multiple-Myeloma-as-Early-as-First-Relapse 
 
ITM Receives Complete Response Letter for ¹⁷⁷Lu-edotreotide (ITM-11)
https://www.itm-radiopharma.com/news/press-releases/press-releases-detail/itm-receives-complete-response-letter-for-177lu-edotreotide-itm-11-763/ 
 
Prader-Willi Researchers Raise Concerns About the Safety of Approved Drug https://www.fpwr.org/blog/vykat-xr-clinician-recommendations-for-real-world-use-and-monitoring-side-effects






Produced by CheckRare.

Explore additional CME activities, physician interviews, podcasts, and rare disease resources at CheckRare.com. Subscribe to the CheckRare Podcast Network for the latest rare disease education, expert interviews, and weekly news.

Part of the CheckRare Podcast Network: Trusted conversations, news, education, and expert insights across the rare disease community.

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On this week’s episode of The CheckRare Brief, we discuss FDA’s approval of Zenbexus (iberdomide) to treat patients with multiple myeloma, the complete response letter issued to ITM-11 to treat patients with neuroendocrine tumors, and safety concerns about VYKAT XR for Prader-Willi syndrome (PWS).
The US Food and Drug Administration (FDA) granted accelerated approval to Bristol Myers Squibb’s iberdomide to treat patients with relapsed or refractory multiple myeloma on August 13, 2026. This treatment is a cereblon E3 ligase modulator (CELMoD), a new therapeutic class of drug. The approval is largely based on results from the EXCALIBER-RRMM clinical trial (NCT04975997), a two-stage, randomized, multicenter, open-label trial in adults with relapsed or refractory MM who had previously received one or two prior lines of therapy. Additionally, another new trend is the outcome measure of minimal residual disease, a departure from more traditional measures such as overall survival or progression free survival.

In other regulatory news, the FDA gave ITM a complete response letter (CRL) for ITM-11, a radioisotope (177-lutetium) attached to a peptide (edotreotide) that emits beta radiation towards targeted tumors, for neuroendocrine tumors. A phase 3 clinical trial showed the treatment to be significantly better than the control group, with a progression free survival of 24 months in the ITM-11 group versus 14 months in the control group. It appears that the FDA's concern wasn't the drug efficacy but about the manufacturing process. While it is a setback, it does not necessarily mean the drug has been rejected permanently. The company can address the FDA's concerns and resubmit the application.

Finally, the Foundation for Prader-Willi Research are voicing concerns about VYKAT XR (diazoxide choline), a treatment approved in 2025 for children with Prader-Willi syndrome to address dysphagia. The main concern has to do with excessive fluid retention occurring in some patients that can lead to other serious adverse events, including cardiac and breathing concerns. The drug was approved last year to treat children with Prader-Willi syndrome to better control their hunger. These concerns highlight the importance of making physicians aware of the drug’s safety and efficacy in a real-world setting following drug approval. 

Sources
FDA Grants Accelerated Approval For Multiple Myeloma Drug
https://www.businesswire.com/news/home/20260811027471/en/U.S.-FDA-Grants-Accelerated-Approval-to-Bristol-Myers-Squibbs-First-CELMoD-Therapy-ZENBEXUS-in-Combination-with-Daratumumab-and-Hyaluronidase-fihj-and-Dexamethasone-ZDd-for-Patients-with-Multiple-Myeloma-as-Early-as-First-Relapse 
 
ITM Receives Complete Response Letter for ¹⁷⁷Lu-edotreotide (ITM-11)
https://www.itm-radiopharma.com/news/press-releases/press-releases-detail/itm-receives-complete-response-letter-for-177lu-edotreotide-itm-11-763/ 
 
Prader-Willi Researchers Raise Concerns About the Safety of Approved Drug https://www.fpwr.org/blog/vykat-xr-clinician-recommendations-for-real-world-use-and-monitoring-side-effects






Produced by CheckRare.

Explore additional CME activities, physician interviews, podcasts, and rare disease resources at CheckRare.com. Subscribe to the CheckRare Podcast Network for the latest rare disease education, expert interviews, and weekly news.

Part of the CheckRare Podcast Network: Trusted conversations, news, education, and expert insights across the rare disease community.

0 0

On this week’s episode of The CheckRare Brief, we discuss FDA’s approval of Zenbexus (iberdomide) to treat patients with multiple myeloma, the complete response letter issued to ITM-11 to treat patients with neuroendocrine tumors, and safety concerns about VYKAT XR for Prader-Willi syndrome (PWS).

The US Food and Drug Administration (FDA) granted accelerated approval to Bristol Myers Squibb’s iberdomide to treat patients with relapsed or refractory multiple myeloma on August 13, 2026. This treatment is a cereblon E3 ligase modulator (CELMoD), a new therapeutic class of drug. The approval is largely based on results from the EXCALIBER-RRMM clinical trial (NCT04975997), a two-stage, randomized, multicenter, open-label trial in adults with relapsed or refractory MM who had previously received one or two prior lines of therapy. Additionally, another new trend is the outcome measure of minimal residual disease, a departure from more traditional measures such as overall survival or progression free survival.

In other regulatory news, the FDA gave ITM a complete response letter (CRL) for ITM-11, a radioisotope (177-lutetium) attached to a peptide (edotreotide) that emits beta radiation towards targeted tumors, for neuroendocrine tumors. A phase 3 clinical trial showed the treatment to be significantly better than the control group, with a progression free survival of 24 months in the ITM-11 group versus 14 months in the control group. It appears that the FDA's concern wasn't the drug efficacy but about the manufacturing process. While it is a setback, it does not necessarily mean the drug has been rejected permanently. The company can address the FDA's concerns and resubmit the application.

Finally, the Foundation for Prader-Willi Research are voicing concerns about VYKAT XR (diazoxide choline), a treatment approved in 2025 for children with Prader-Willi syndrome to address dysphagia. The main concern has to do with excessive fluid retention occurring in some patients that can lead to other serious adverse events, including cardiac and breathing concerns. The drug was approved last year to treat children with Prader-Willi syndrome to better control their hunger. These concerns highlight the importance of making physicians aware of the drug’s safety and efficacy in a real-world setting following drug approval.

2 2

On this week’s episode of The CheckRare Brief, we discuss FDA’s approval of Zenbexus (iberdomide) to treat patients with multiple myeloma, the complete response letter issued to ITM-11 to treat patients with neuroendocrine tumors, and safety concerns about VYKAT XR for Prader-Willi syndrome (PWS).
The US Food and Drug Administration (FDA) granted accelerated approval to Bristol Myers Squibb’s iberdomide to treat patients with relapsed or refractory multiple myeloma on August 13, 2026. This treatment is a cereblon E3 ligase modulator (CELMoD), a new therapeutic class of drug. The approval is largely based on results from the EXCALIBER-RRMM clinical trial (NCT04975997), a two-stage, randomized, multicenter, open-label trial in adults with relapsed or refractory MM who had previously received one or two prior lines of therapy. Additionally, another new trend is the outcome measure of minimal residual disease, a departure from more traditional measures such as overall survival or progression free survival.

In other regulatory news, the FDA gave ITM a complete response letter (CRL) for ITM-11, a radioisotope (177-lutetium) attached to a peptide (edotreotide) that emits beta radiation towards targeted tumors, for neuroendocrine tumors. A phase 3 clinical trial showed the treatment to be significantly better than the control group, with a progression free survival of 24 months in the ITM-11 group versus 14 months in the control group. It appears that the FDA's concern wasn't the drug efficacy but about the manufacturing process. While it is a setback, it does not necessarily mean the drug has been rejected permanently. The company can address the FDA's concerns and resubmit the application.

Finally, the Foundation for Prader-Willi Research are voicing concerns about VYKAT XR (diazoxide choline), a treatment approved in 2025 for children with Prader-Willi syndrome to address dysphagia. The main concern has to do with excessive fluid retention occurring in some patients that can lead to other serious adverse events, including cardiac and breathing concerns. The drug was approved last year to treat children with Prader-Willi syndrome to better control their hunger. These concerns highlight the importance of making physicians aware of the drug’s safety and efficacy in a real-world setting following drug approval. 

Sources
FDA Grants Accelerated Approval For Multiple Myeloma Drug
https://www.businesswire.com/news/home/20260811027471/en/U.S.-FDA-Grants-Accelerated-Approval-to-Bristol-Myers-Squibbs-First-CELMoD-Therapy-ZENBEXUS-in-Combination-with-Daratumumab-and-Hyaluronidase-fihj-and-Dexamethasone-ZDd-for-Patients-with-Multiple-Myeloma-as-Early-as-First-Relapse 
 
ITM Receives Complete Response Letter for ¹⁷⁷Lu-edotreotide (ITM-11)
https://www.itm-radiopharma.com/news/press-releases/press-releases-detail/itm-receives-complete-response-letter-for-177lu-edotreotide-itm-11-763/ 
 
Prader-Willi Researchers Raise Concerns About the Safety of Approved Drug https://www.fpwr.org/blog/vykat-xr-clinician-recommendations-for-real-world-use-and-monitoring-side-effects






Produced by CheckRare.

Explore additional CME activities, physician interviews, podcasts, and rare disease resources at CheckRare.com. Subscribe to the CheckRare Podcast Network for the latest rare disease education, expert interviews, and weekly news.

Part of the CheckRare Podcast Network: Trusted conversations, news, education, and expert insights across the rare disease community.

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Byron Wade, a patient with IgA nephropathy (IgAN), discusses his personal diagnostic journey and a recent study looking at other patients’ experiences.

IgAN is characterized by the accumulation of IgA antibodies in the kidneys. In the early stages, patients with IgAN have no symptoms. The first sign of this condition may be blood in the urine. End-stage kidney disease may develop if the disease is not treated properly. In most instances, the cause of this condition is unknown; however, certain disorders have been linked with IgAN, such as cirrhosis of the liver, celiac disease, and HIV infection. The condition can also often be triggered by a viral illness.

Mr. Wade explains how at the time of his diagnosis in 2020, the most difficult part was the unknown. In 2020, IgAN was an even lesser known condition than it remains today and no approved treatments existed. While management with steroids and blood pressure medications were the initial treatment plan, Mr. Wade eventually required a kidney transplant in 2023. His hope for patients with IgAN moving forward, with greater awareness of the condition and several treatment options approved or in late stage development, is that other patients are able to avoid his struggles.

A study presented at GlomCon highlighted the experiences of patients with IgAN throughout different stages of their disease, of which Mr. Wade was a co-author.

Key findings showed that a vast majority of patients recalled experiencing symptoms prior to diagnosis, but waited about 9 months before seeking. Patients reported that typically abnormal lab results were usually what led to referral to a nephrologist, but these wait times could be up to 12 months. Additionally, many patients leave their appointments feeling confused and wanting clearer guidance on their disease and treatment options. Patients also indicated large gaps between what they value and how current treatments perform.

CHAPTERS
Introduction 00:00
Most Difficult Part of Diagnosis 00:36
Diagnostic Journey 1:48
Advice for Newly Diagnosed Patients 4:02
Effect on Daily Life 4:37
What Physicians Should Know 5:18
Patient Experiences With IgAN 6:03
Take Home Message 7:08

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