A Study to Assess the Safety and Tolerability of Nusinersen (ISIS 396443) in Participants With Spinal Muscular Atrophy (SMA).

Exclusion Criteria

• •Meets additional study related criteria.
• •Any previous exposure to ISIS 396443; previous dosing in this study or previous studies with ISIS 396443.
• •Signs or symptoms of SMA present at birth or within the first week after birth.
• •Ventilation for ≥16 hours per day continuously for \>21 days at screening.
• •Permanent tracheostomy, implanted shunt for CSF drainage, or implanted central nervous system (CNS) catheter at screening.
• •History of brain or spinal cord disease that would interfere with the LP procedure, CSF circulation, or safety assessments.
• •Hospitalization for surgery (e.g., scoliosis surgery), pulmonary event, or nutritional support within 2 months prior to screening, or hospitalization for surgery planned during the study.
• •Clinically significant abnormalities in hematology or clinical chemistry parameters or Electrocardiogram (ECG), as assessed by the Investigator.
• •Treatment with an investigational drug for SMA (e.g., albuterol/salbutamol, riluzole, carnitine, sodium phenylbutyrate, valproate, hydroxyurea), biological agent, or device within 30 days prior to screening. Any history of gene therapy, prior antisense oligonucleotide (ASO) treatment, or cell transplantation.
• •For Part 2 only:
• •To be eligible to participate in Part 2 of this study, participants must meet the following eligibility criteria at the time of consent to participate in Part 2:
• •Participation in Part 1 and completion of the End of Part 1 Evaluation assessments.
• •Ability of parent(s) or legal guardian(s) to understand the purpose and risks of the study and to provide signed and dated informed consent on the Part 2 informed consent form (ICF) and authorization to use confidential health information in accordance with national and local participant privacy regulations.
• •Able to complete all study procedures, measurements, and visits, and parent or legal guardian/participant has adequately supportive psychosocial circumstances, in the opinion of the Investigator.
• •Participants will be excluded from the Part 2 if they meet the following exclusion criterion at the time of consent into Part 2 of the study:
• •Any significant change in clinical status, including laboratory tests that, in the opinion of the Investigator, would make them unsuitable to participate in Part 2. The Investigator must reassess the subject's medical fitness for participation and consider any diseases that would preclude treatment.