

Drug discovery
25
drugs
With orphan designations
Overview
Neuronal ceroid lipofuscinosis (NCL), also called Batten disease, comprises 13 rare genetic neurodegenerative lysosomal storage disorders characterized by progressive vision loss, seizures, motor/cognitive decline, and premature death. Autosomal recessive inheritance predominates (except adult-onset CLN4), with pathogenic variants in CLN1-CLN8, CLN10-CLN14 causing toxic lipofuscin accumulation. Diagnosis combines clinical evaluation, genetic testing, and histopathology [1][6][9].
Burden
Mortality: Infantile forms (e.g., CLN1) often fatal by age 10; juvenile forms (CLN3) lead to death in teens/early adulthood [1][2][6].
Disability: Progressive blindness, dementia, and loss of mobility necessitate 24/7 care [1][14].
Caregiver impact: High financial/emotional strain, reduced quality of life, and significant time commitment [14][19].
Therapies
FDA-approved: Cerliponase alfa (intracerebroventricular ERT for CLN2) slows motor decline [6][13].
Experimental: Gene therapy (AAV-based CLN3/CLN6/CLN8), stem cell therapy, and immunomodulators target neuroinflammation [3][12][18].
Symptomatic care: Anticonvulsants, muscle relaxants, and multidisciplinary support remain mainstays [1][6][11].
Categories: rare genetic diseases, rare inborn errors of metabolism, rare neurological diseases
Drug Discovery Landscape
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
Adeno-associated viral vector serotype rh.10 encoding the CLN2 gene | gene therapies | EMA | 2022-10-11 | — | Scendea (NL) B.V. |
Tamoxifen citrate | small molecules | EMA | 2022-06-21 | — | Fondazione Telethon Ets |
Autologous CD34+ haematopoietic stem and progenitor cells genetically modified with the lentiviral vector encoding for the human palmitoyl-protein thioesterase 1 gene | gene therapies | EMA | 2021-07-19 | — | University of Padua |
Adeno-associated viral vector encoding the human ceroid lipofuscinosis neuronal type 2 (CLN2) gene | gene therapies | FDA | 2021-07-12 | — | Lexeo Therapeutics |
Adeno-associated virus serotype 9 expressing human CLN5 | gene therapies | EMA | 2021-06-21 | — | Eusme Limited |
miglustat | small molecules | FDA | 2021-01-19 | — | Beyond Batten Disease Foundation |
Trehalose | small molecules | FDA | 2020-10-21 | — | Beyond Batten Disease Foundation |
Miglustat | small molecules | EMA | 2020-10-19 | — | Theranexus S.A.S. |
Trehalose | small molecules | EMA | 2020-10-19 | — | Theranexus S.A.S. |
Trehalose + miglustat | small molecules | FDA | 2020-08-10 | — | Beyond Batten Disease Foundation |
Adeno-associated virus serotype 9 vector with engineered transgene encoding the human CLN5 gene | gene therapies | FDA | 2020-06-03 | — | Neurogene Inc. |
Recombinant self-complementary adeno-associated viral vector serotype 9 containing the human CLN6 gene | gene therapies | EMA | 2019-08-21 | — | Pharma Gateway AB |
Recombinant self-complementary adeno-associated viral vector serotype 9 containing the human CLN3 gene | gene therapies | EMA | 2019-08-21 | — | Pharma Gateway AB |
non-replicating, recombinant adeno-associated virus (AAV) serotype 9 (AAV9) vector containing an hCLN2 expression cassette encoding for the soluble lysosomal enzyme tripeptidyl peptidase I (TPP1) | gene therapies | FDA | 2018-10-25 | — | Tern Therapeutics LLC |
Adeno-associated viral vector serotype 9 containing the human CLN1 gene | gene therapies | EMA | 2018-05-25 | — | Raremoon Consulting Esp S.L. |
Gemfibrozil | small molecules | EMA | 2018-03-21 | — | Premier Research Group S.L. |
a self-complementary adeno-associated virus serotype 9 expressing human codon-optimized CLN1 under control of CBh | gene therapies | FDA | 2018-02-07 | — | Taysha Gene Therapies, Inc. |
gemfibrozil and vitamin A | small molecules | FDA | 2017-12-06 | — | Polaryx Therapeutics, Inc. |
gemfibrozil | small molecules | FDA | 2017-08-02 | — | Polaryx Therapeutics, Inc. |
recombinant human palmitoyl-protein thioeserase-1 (rhPPT1) | proteins | FDA | 2017-06-05 | — | Collaborations Pharmaceuticals, Inc. |
RECOMBINANT SELF-COMPLEMENTARY ADENO-ASSOCIATED VIRAL VECTOR SEROTYPE 9 CONTAINING THE HUMAN CLN3 GENE [ABO-201] | gene therapies | EMA | 2016-12-12 | — | [INACTIVE] Abeona Therapeutics Europe S.L. |
N-t-butylhydroxylamine | small molecules | FDA | 2015-05-12 | — | Circumvent Pharmaceuticals |
cerliponase alfa [Brineura] | proteins | FDA | 2013-04-01 | 2017-04-27 | BioMarin Pharmaceutical, Inc. |
Recombinant human tripeptidyl-peptidase 1 [Brineura] | proteins | EMA | 2013-03-12 | 2017-06-01 | BioMarin International Limited |
cysteamine | small molecules | FDA | 2008-08-06 | — | Raptor Pharmaceuticals, Inc. |