TheraRadar
Data updated: Jun 28, 2026

Zolgensma (onasemnogene abeparvovec-xioi) · Novartis

Approved 2019-05-23

ZOLGENSMA is an adeno-associated virus (AAV) vector-based gene therapy indicated for the treatment of pediatric patients less than 2 years of age with spinal muscular atrophy (SMA) with bi-allelic mutations in the survival motor neuron 1 (SMN1) gene. Limitations of Use The safety and effectiveness of repeat administration of ZOLGENSMA have not been evaluated [see Adverse Reactions ] . The use of ZOLGENSMA in patients with advanced SMA (e.g.

Source: FDA Label
BLA
Biologic
1
Indication
--
Phase 3 Trials
7
Years on Market

Details

Status
Prescription
First Approved
2019-05-23
Patent Cliff
2031
Revenue
$307M (Q4-2025)

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Routes
Intravenous
Dosage Forms
Injection

Companies

Active Ingredient: onasemnogene abeparvovec-xioi

Zolgensma Approval History

2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
1 FDA actions from 2019 to 2019
May 2019 ORIGINAL
Update · CBER biologic (Purple Book)

What Zolgensma Treats

1 FDA approvals

Originally approved for its first indication in 2019 .

  • Other (1)

Zolgensma Boxed Warning

SERIOUS LIVER INJURY and ACUTE LIVER FAILURE Cases of acute liver failure with fatal outcomes have been reported. Acute serious liver injury and elevated aminotransferases can also occur with ZOLGENSMA [see Warnings and Precautions ( 5.1 )]. Patients with preexisting liver impairment may be at higher risk [see Warnings and Precautions ( 5.1 )]. Prior to infusion, assess liver function of all patients by clinical examination and laboratory testing. Administer systemic corticosteroid to all patien...

Zolgensma Competitive Set

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Three rings of competition based on shared molecular targets and treated indications.

MoA expansion candidates

1

Same target(s), different indications — where else is this mechanism being explored?

Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

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Clinical Trial Registry

6 trials
Trial Sponsor ID Phase Status Title
NCT03381729 STRONG results posted AVXS-101-CL-102 2020-003678-28, COAV101A12102 Ph 1 terminated Study of Intrathecal Administration of Onasemnogene Abeparvovec-xioi for Spinal Muscular Atrophy
NCT03306277 STR1VE results posted AVXS-101-CL-303 2020-000095-38, COAV101A12302 Ph 3 completed Gene Replacement Therapy Clinical Trial for Participants With Spinal Muscular Atrophy Type 1
NCT03837184 results posted AVXS-101-CL-306 194664, 201900208 Ph 3 completed Single-Dose Gene Replacement Therapy Using for Patients With Spinal Muscular Atrophy Type 1 With One or Two SMN2 Copies
NCT03505099 SPR1NT results posted AVXS-101-CL-304 2017-004087-35, JapicCTI-184203 Ph 3 completed Pre-Symptomatic Study of Intravenous Onasemnogene Abeparvovec-xioi in Spinal Muscular Atrophy (SMA) for Patients With Multiple Copies of SMN2
NCT03461289 STRIVE-EU results posted AVXS-101-CL-302 2017-000266-29, COAV101A12301 Ph 3 completed Single-Dose Gene Replacement Therapy Clinical Trial for Participants With Spinal Muscular Atrophy Type 1
NCT04042025 AVXS-101-LT-002 2019-002611-26, 205305 Ph 3 active not recruiting Long-term Follow-up Study of Patients Receiving Onasemnogene Abeparvovec-xioi
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Active Pipeline

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Key Completed Trials

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

Zolgensma FDA Label Details

Indications & Usage

ZOLGENSMA is an adeno-associated virus (AAV) vector-based gene therapy indicated for the treatment of pediatric patients less than 2 years of age with spinal muscular atrophy (SMA) with bi-allelic mutations in the survival motor neuron 1 (SMN1) gene. Limitations of Use The safety and effectiveness of repeat administration of ZOLGENSMA have not been evaluated [see Adverse Reactions ] . The use of ZOLGENSMA in patients with advanced SMA (e.g., complete paralysis of limbs, permanent ventilator-dependence) has not been evaluated [see Clinical Studies ] . ZOLGENSMA is an adeno-associated virus (AAV...

⚠️ BOXED WARNING

WARNING: SERIOUS LIVER INJURY and ACUTE LIVER FAILURE Cases of acute liver failure with fatal outcomes have been reported. Acute serious liver injury and elevated aminotransferases can also occur with ZOLGENSMA [see Warnings and Precautions ( 5.1 )]. Patients with preexisting liver impairment may be...

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Revenue Insights

  • Q4-2025: $307M
  • Historical trend analysis

Patent Timeline

  • Cliff: 2031
  • Generic/biosimilar risk

Trial Analysis

  • Clinical trial tracking
  • Development stage analysis

Competitive Landscape

  • Competitor tracking
  • Same target/indication analysis
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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.