PMID- 38272714 OWN - NLM STAT- MEDLINE DCOM- 20240219 LR - 20240219 IS - 1471-499X (Electronic) IS - 1471-4914 (Linking) VI - 30 IP - 2 DP - 2024 Feb TI - Omaveloxolone: a groundbreaking milestone as the first FDA-approved drug for Friedreich ataxia. PG - 117-125 LID - S1471-4914(23)00281-2 [pii] LID - 10.1016/j.molmed.2023.12.002 [doi] AB - Friedreich ataxia (FA) is an inherited autosomal recessive neurodegenerative disease (NDD) characterized primarily by progressive sensory and spinocerebellar ataxia associated with hypertrophic cardiomyopathy. FA is due to an intronic GAA repeat expansion within the frataxin gene (FXN) leading to reduced levels of frataxin (FXN) which causes mitochondrial dysfunction, production of reactive oxygen species (ROS), and altered iron metabolism. To date there is no resolutive cure for FA; however, the FDA has recently approved omaveloxolone - a potent activator of nuclear factor erythroid 2-related factor 2 (NRF2) - as the first treatment for FA. We discuss herein the urgency to find a resolutive cure for NDDs that will most probably be achieved via combinatorial therapy targeting multiple disease pathways, and how omavaloxolone serves as an example for future treatments. CI - Copyright (c) 2023 Elsevier Ltd. All rights reserved. FAU - Pilotto, Federica AU - Pilotto F AD - Institut NeuroMyoGene (INMG), Unite Physiopathologie et Genetique du Neurone et du Muscle, Universite Claude Bernard Lyon 1 CNRS UMR 5261, Inserm U1315, Lyon, France. FAU - Chellapandi, Deepika M AU - Chellapandi DM AD - Institut NeuroMyoGene (INMG), Unite Physiopathologie et Genetique du Neurone et du Muscle, Universite Claude Bernard Lyon 1 CNRS UMR 5261, Inserm U1315, Lyon, France. FAU - Puccio, Helene AU - Puccio H AD - Institut NeuroMyoGene (INMG), Unite Physiopathologie et Genetique du Neurone et du Muscle, Universite Claude Bernard Lyon 1 CNRS UMR 5261, Inserm U1315, Lyon, France. Electronic address: helene.puccio@inserm.fr. LA - eng PT - Journal Article PT - Review DEP - 20240124 PL - England TA - Trends Mol Med JT - Trends in molecular medicine JID - 100966035 RN - G69Z98951Q (omaveloxolone) RN - 0 (Triterpenes) RN - 0 (Frataxin) SB - IM MH - Humans MH - *Friedreich Ataxia/drug therapy/genetics/metabolism MH - *Neurodegenerative Diseases MH - *Triterpenes/therapeutic use MH - *Cardiomyopathy, Hypertrophic MH - Frataxin OTO - NOTNLM OT - Friedreich's ataxia OT - NRF2 pathway OT - ferroptosis OT - neurodegenerative diseases OT - omaveloxolone OT - oxidative stress COIS- Declaration of interests The authors declare no competing interests. EDAT- 2024/01/26 00:44 MHDA- 2024/02/19 06:42 CRDT- 2024/01/25 21:52 PHST- 2023/10/23 00:00 [received] PHST- 2023/12/01 00:00 [revised] PHST- 2023/12/04 00:00 [accepted] PHST- 2024/02/19 06:42 [medline] PHST- 2024/01/26 00:44 [pubmed] PHST- 2024/01/25 21:52 [entrez] AID - S1471-4914(23)00281-2 [pii] AID - 10.1016/j.molmed.2023.12.002 [doi] PST - ppublish SO - Trends Mol Med. 2024 Feb;30(2):117-125. doi: 10.1016/j.molmed.2023.12.002. Epub 2024 Jan 24.