An Intrathecal Therapeutics Clinic for Administration of Tofersen in Amyotrophic Lateral Sclerosis: A Canadian Nurse Practitioner and Neurologist Collaborative Model.

Tofersen is an antisense oligonucleotide administered intrathecally for amyotrophic lateral sclerosis (ALS) caused by pathogenic variants in the superoxide dismutase 1 gene. Delivering intrathecal treatments required for ongoing therapy poses logistical challenges for multidisciplinary clinics. We describe our experience establishing an efficient Canadian nurse practitioner-and neurologist-led intrathecal therapeutics clinic model, with standardized procedures and multidisciplinary monitoring. This collaborative approach has enabled efficient monthly delivery of tofersen within existing clinic infrastructure. As intrathecal therapies expand in ALS and other neurological diseases, scalable multidisciplinary models such as this may support safe and equitable care.