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Baliforsen (also known as ISIS 598769 or IONIS-DMPKRx) is an antisense oligonucleotide (ASO) developed by Ionis Pharmaceuticals in collaboration with Biogen for the treatment of myotonic dystrophy type 1 (DM1). The drug is designed to target the DMPK (DM1 protein kinase) mRNA transcript, specifically binding within exon 9 to promote RNase H1-mediated degradation of the toxic expanded CUG repeat-containing RNA. By reducing the levels of this toxic RNA, baliforsen aims to alleviate the sequestration of muscleblind-like (MBNL) proteins and restore normal alternative splicing. Although evaluated in a Phase 1/2a trial (NCT02312011), the program was discontinued for this specific candidate because skeletal muscle drug concentrations were insufficient to achieve the necessary target reduction for clinical efficacy.
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