Advancing Friedreich Ataxia Treatment With FDA-Approved Therapies

An expert discusses how omaveloxolone is a nuclear factor erythroid 2-related factor 2 (Nrf2) activator that addresses oxidative stress and mitochondrial dysfunction in Friedreich ataxia. It works by binding to Keap1, which releases Nrf2 to enter the nucleus and upregulate antioxidant genes. Clinical trials showed modest improvements in neurological function, as measured by modified Friedreich Ataxia Rating Scale scores. Adverse effects include headache, nausea, and elevated liver enzymes. Omaveloxolone has been integrated into clinical practice as part of multidisciplinary care, requiring regular monitoring and coordination with physical therapy, cardiology, and other specialties.