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A neurogenetic disorder characterized by severe intellectual deficit and distinct facial dysmorphic features.
Features include always present findings: Delayed ability to walk, Global developmental delay, and Secondary microcephaly; and very common findings: Cerebral cortical atrophy, Seizure, Ataxia, and Motor delay and others. 89 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 30 | Cerebral cortical atrophy, Seizure, Ataxia |
Digestive system | 9 | Feeding difficulties in infancy, Constipation, Gastroesophageal reflux |
Eyes | 7 | Strabismus, Nystagmus, Ptosis |
Head and neck | 5 | Secondary microcephaly, Hypoplasia of the maxilla, Mandibular prognathia |
Muscles | 4 | Cerebral cortical atrophy, Low muscle tone (hypotonia), Generalized hypotonia |
Arms and legs | 2 | Limb tremor, Recurrent hand flapping |
Skin | 1 | Hypopigmentation of the skin |
Bones and joints | 1 | Sideways curvature of the spine (scoliosis) |
Hormones | 1 | Precocious puberty in females |
Angelman syndrome (AS) is characterized by severe developmental delay and intellectual disability, severe speech impairment, gait ataxia and/or tremulousness of the limbs, and a unique behavior with an apparent happy demeanor that includes frequent laughing, smiling, and excitability. Microcephaly and seizures are also common. Developmental delays are first noted at around age six months; however, the unique clinical features of AS do not become manifest until after age one year. Table 2. Angelman Syndrome: Frequency of Select Features
Feature | % of Persons with Feature | Comment |
|---|---|---|
Seizures | 90% | Many seizure types; nonconvulsive status epilepticus in 20% |
Nonepileptic myoclonus | 20% |
UBE3A function has not been fully characterized.
Angelman syndrome is caused by mutations in the UBE3A gene on chromosome 15.
All molecular causes of AS lead to a similar phenotype of severe-to-profound intellectual disability, movement disorder, characteristic behaviors, and severe limitations in speech and language. However, some phenotypic differences correlate with genotype [, , , ]. These correlations are broadly summarized here:
Source: GeneReviews — "Angelman Syndrome"
UBE3A pathogenic variants, imprinting center deletions, very small 15q11.2-q13 deletions that include UBE3A , and certain chromosome translocations affecting the paternal allele may be non-penetrant .
Source: GeneReviews — "Angelman Syndrome"
Consensus criteria for the clinical diagnosis of Angelman syndrome (AS) have been developed in conjunction with the Scientific Advisory Committee of the US Angelman Syndrome Foundation . Several reviews are available .
AS should be suspected in individuals with the following clinical, laboratory, and radiographic findings.
Clinical
Source: GeneReviews — "Angelman Syndrome"
Infants with Angelman syndrome (AS) commonly present with nonspecific psychomotor delay and/or seizures; therefore, the differential diagnosis is broad and nonspecific, encompassing such entities as cerebral palsy, static encephalopathy, or mitochondrial encephalomyopathy. The tremulousness and jerky limb movements seen in most infants with AS may help distinguish AS from these conditions. AS-mimicking conditions have been reviewed and many of these, as well as additional disorders to consider in the differential diagnosis, are listed in . Table 3. Genes of Interest in the Differential Diagnosis of Angelman Syndrome
Gene | Disorder | MOI | Characteristic Features | Distinguishing Features |
|---|---|---|---|---|
ADSL | Adenylosuccinate lyase deficiency (ADSLD, OMIM 103050) |
Genetic testing for UBE3A is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for Angelman syndrome has been reported in the published literature.
No approved treatments are currently available for Angelman syndrome. An additional 13 compounds hold orphan drug designation.
Standard-of-care therapies for Angelman syndrome include treatments and supportive measures that are widely used in clinical practice, even when they are not FDA-approved specifically for this condition. These represent first-line care and are curated from clinical guidelines.
- Seizure management (often requires multiple antiepileptic medications; valproate and benzodiazepines often used)
- Physical therapy for motor development and gait
- Speech therapy and augmentative/alternative communication (AAC)
- Behavioral interventions for sleep disturbances
- Occupational therapy for daily living skills
While no drugs are FDA-approved specifically for Angelman syndrome, some of the following designated compounds may be used off-label in clinical practice. Treatment decisions should be made in consultation with a specialist familiar with this condition.
The following drugs have received orphan drug designation from the FDA for Angelman syndrome. Orphan designation reflects regulatory interest and does not indicate approval for treatment.
Brand Name | Generic Name | Sponsor | Designated | Exclusivity End | Designation Status |
|---|---|---|---|---|---|
non-replicating recombinant adeno-associated virus serotype hu68 (AAVhu68) vector, which expresses a variant of the UBE3A gene | non-replicating recombinant adeno-associated virus serotype hu68 (AAVhu68) vector, which expresses a variant of the UBE3A gene | MavriX Bio, LLC | 2025 | — | Designated |
insulin like growth factor 2 receptor ligand | insulin like growth factor 2 receptor ligand | New York University | 2024 | — | Designated |
No clinical practice guidelines for Angelman syndrome (AS) have been published. Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with AS, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. Recommended Evaluations Following Initial Diagnosis in Individuals with Angelman Syndrome
System/Concern | Evaluation | Comment |
|---|---|---|
Neurologic | Neurologic eval | To incl brain MR, EEG Development |
behavior | Developmental behavioral assessment | To incl:; Motor, adaptive, cognitive, nonverbal language ability; Language ability need for special communication devices; Eval for early intervention / special education; Screening for behavior concerns incl sleep disturbances Gastrointestinal/ |
Overtreatment
Children with AS are at risk for medication overtreatment because their movement abnormalities can be mistaken for seizures and because EEG abnormalities can persist even when seizures are controlled.
The behavioral phenotype of AS includes hyperexcitability, hypermotoric behaviors, and deficits in social communication. These limitations place affected individuals at risk for social disruptions. On occasion, the use of risperidone (Risperdal®) or other atypical antipsychotic drugs provides some but often limited benefit. When such drugs are needed, care must be taken to avoid oversedation and other side effects.
Source: GeneReviews — "Angelman Syndrome"
Clinical trials involving oral administration of folate, vitamin B12, creatine, and betaine have been undertaken in an attempt to augment DNA methylation pathways and possibly increase expression of the paternal UBE3A allele in the central nervous system; however, the initial trial did not demonstrate significant clinical benefit . An ongoing study using oral gaboxadol, a highly selective GABA receptor agonist, has not yet shown clear benefit . A study of oral levodopa/carbidopa did not show significant benefit in AS . Two clinical trials are currently evaluating antisense oligonucleotide-mediated enhancement of UBE3A expression: one trial is sponsored by HoffmannLa Roche (molecule RO7248824; NCT04428281) and the other is sponsored by GeneTX Biotherapeutics (molecule GTX-102; NCT04259281).
Source: GeneReviews — "Angelman Syndrome"
20 trials found
Table 6.
Recommended Surveillance for Individuals with Angelman Syndrome
System/Concern | Evaluation | Frequency
| • Monitor those w/seizures as clinically indicated.
Assess for new manifestations incl seizures, changes in tone, movement disorders.
| At each visit
| • Monitor developmental progress educational needs.
Speech assessment
Psychiatric/
| Behavioral assessment for hypermotoric/self-injurious behavior, sleep disturbance
| Physical medicine, OT/PT assessment of mobility, self-help skills
| Monitor for gastroesophageal reflux constipation.
Nutrition/
| • Measurement of growth parameters
Eval of nutritional status
Eval of older children for obesity
Eyes | Ophthalmology exam | In 1st yr if strabismusis present; generaleval by age 2 yrs;follow up perophthalmologist
| Clinical exam | Annually
OT = occupational therapy; PT = physical therapy
Source: GeneReviews — "Angelman Syndrome"
Phenotype severity distribution: 3 always present features, 20 very common features, 20 common features.
Estimated prevalence: 1-9 in 100,000 (Uncommon).
20 clinical trials registered, 3 recruiting. Interventions under study include other interventions, drug therapy, procedural interventions, and gene therapy. Pipeline includes 5 PHASE3, 1 PHASE2, 2 PHASE1. Research is sponsored by a mix of industry and academic institutions.
NCT ID | Title | Phase | Sponsor | Status |
|---|---|---|---|---|
[NCT06353620](https://clinicaltrials.gov/study/NCT06353620) | Structural-functional Connectome in Drug-resistant Epilepsies and Neurodevelopmental Syndromes With Epilepsy | — | IRCCS Eugenio Medea | RECRUITING |
[NCT04507997](https://clinicaltrials.gov/study/NCT04507997) | Angelman Syndrome Natural History Study | — | Boston Children's Hospital | RECRUITING |
[NCT05945576](https://clinicaltrials.gov/study/NCT05945576) | IDMet (RaDiCo Cohort) (RaDiCo-IDMet) | — | Institut National de la Santé Et de la Recherche Médicale, France | RECRUITING |
287 publications have been identified in PubMed for Angelman syndrome. Research spans Basic Science / Preclinical (32%), Review / Meta-Analysis (21%), and Epidemiology / Natural History (15%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 93 | 32% |
Research summaries | 61 | 21% |
Disease patterns and progression | 43 | 15% |
Testing and diagnosis research | 29 | 10% |
Patient case studies | 28 | 10% |
New treatment approaches | 15 |
Shim Y (2026). [PMID: 41630268](https://pubmed.ncbi.nlm.nih.gov/41630268/). *Medicine (Baltimore)*. [Epidemiology / Natural History]
Krzeski JC (2026). [PMID: 41652151](https://pubmed.ncbi.nlm.nih.gov/41652151/). *Mol Psychiatry*. [Basic Science / Preclinical]
Smeenk H (2026). [PMID: 41764319](https://pubmed.ncbi.nlm.nih.gov/41764319/). *Sci Rep*. [Gene Therapy / Novel Therapeutics]
Pombo DSD (2026). [PMID: 42531823](https://pubmed.ncbi.nlm.nih.gov/42531823/). *J Chromatogr A*. [Basic Science / Preclinical]
Alberti S (2026). [PMID: 42768751](https://pubmed.ncbi.nlm.nih.gov/42768751/). *Mol Ther*. [Review / Meta-Analysis]
Geier B (2026). [PMID: 41545316](https://pubmed.ncbi.nlm.nih.gov/41545316/). *Fly (Austin)*. [Basic Science / Preclinical]
Shen Y (2026). [PMID: 40944492](https://pubmed.ncbi.nlm.nih.gov/40944492/). *Ann Neurol*. [Basic Science / Preclinical]
Khalid A (2026). [PMID: 42292720](https://pubmed.ncbi.nlm.nih.gov/42292720/). *Cureus*. [Case Report / Case Series]
Chin HL (2026). [PMID: 42434914](https://pubmed.ncbi.nlm.nih.gov/42434914/). *Epileptic Disord*. [Diagnostic / Biomarker]
Vihma H (2026). [PMID: 41632831](https://pubmed.ncbi.nlm.nih.gov/41632831/). *JCI Insight*. [Basic Science / Preclinical]
Data assembled from 10 of 12 sources · Last updated Nov 3, 2026, 7:21 PM UTC
Patient Advocacy Groups (PAGs) provide support, resources, and community for patients and caregivers.
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Sleep problems | 80%-90% | Frequent awakening, dyssomnias, irregular sleep-wake cycles |
Behavioral features | 100% | Hypermotoric activity, oral exploration, frequent smiling laughter, aggression, anxiety, autism spectrum traits |
Motor delay / tremor | 100% | — |
Language delay /Cognitive impairment | 100% | Persons mosaic for imprinting center defects demonstrate better language development. |
Feeding/GI issues | 85% | — |
Microcephaly1 | 25%-80% | Apparent by age 2 yrs; most common in those w/15q11.2-q13 deletion |
Characteristic facial features | 80% | Flat occiput, occipital groove, wide mouth, widely spaced teeth, protruding tongue, prognathia; ± light hair, skin, eyes |
Strabismus | 40%-50% | — |
Scoliosis | ≤50% | Children: 10%-30%; adults: 30%-50% GI = gastrointestinal 1. Seizure onset typically occurs between ages one and three years but can occur at any age; most appear by age five years. Epilepsy occurs in up to 90% of individuals and is more commonly observed in those with 15q11.2-q13 deletions . |
Source: GeneReviews — "Angelman Syndrome"
AR |
Psychomotor disability, autistic features, hypotonia, seizures, motor apraxia, severe speech deficits, excessive laughter, very happy disposition, hyperactivity, short attention span, mouthing of objects, tantrums, stereotypic movements |
In ADSLD: brain MRI may show cerebral /or cerebellar atrophy. ATRX |
Alpha-thalassemia X-linked ID syndrome (ATR-X) | XL | Microcephaly, hypotonia, drooling, GERD, affable behavior | In ATR-X: genital skeletal abnormalities EHMT1 | — |
Kleefstra syndrome (KS) | AD | Moderate-to-severe ID w/severe speech delay, childhood hypotonia | In KS: distinctive facial features (synophrys, everted vermilion of lower lip) speech ability; mildly affected persons may have 100-word vocab speak in sentences. | — |
HERC2 | HERC2-ID (OMIM 615516) | AR | DD, ID, hypotonia, delayed independent ambulation (age 2.5-5 yrs), a broad-based gait w/arms upheld flexed at the elbow when running | In HERC2-ID: absence of easily provoked laughter (in some persons) relatively mild ID MBD5 |
MBD5 haploinsufficiency | AD | DD, ID, severe speech impairment, seizures, sleep disturbances, abnormal behaviors (e.g. autistic-like behaviors, self-injury, aggression) | Tremulous movements or happy, excitable behavior may not be present in MBD5 haploinsufficiency. MECP2 | — |
Rett syndrome | XL | In females, partial/complete loss of acquired purposeful hand skills of acquired spoken language or language skill (e.g., babble); gait abnormalities; stereotypic hand movements (e.g., hand wringing/squeezing, clapping/tapping, mouthing, washing/rubbing automatisms) | In Rett syndrome: a neuroregressive course, lack of purposeful use of hands, (usually) absence of a distinctive happy demeanor | — |
MECP2 duplication syndrome | XL | In males1, severe-to-profound ID w/limited or absent speech, early-onset hypotonia w/very slow motor development, seizures | In MECP2 duplication syndrome: progressive spasticity esp of lower limbs, predisposition to infection manifest as recurrent respiratory infections | — |
MTHFR | Severe MTHFR deficiency (See Homocystinuria due to MTHFR Deficiency.) | AR | Reported in a boy w/happy demeanor... | — |
Source: GeneReviews — "Angelman Syndrome"
14-species commensal bacterial flora with prebiotics and postbiotic complex composed of gut microbiome modulating formulation |
14-species commensal bacterial flora with prebiotics and postbiotic complex composed of gut microbiome modulating formulation |
Biom Pharmaceutical Corporation |
2024 |
— |
Designated |
2'-O-(2-methoxyethyl) modified antisense oligonucleotide targeting UBE3A antisense transcript RNA | 2'-O-(2-methoxyethyl) modified antisense oligonucleotide targeting UBE3A antisense transcript RNA | Ionis Pharmaceuticals, Inc. | 2022 | — | Designated |
Cannabidiol | Cannabidiol | Benuvia Operations LLC | 2022 | — | Designated |
UBE3A antisense oligonucleotide with locked nucleic acids (UBE3A-ATS-LNA) | UBE3A antisense oligonucleotide with locked nucleic acids (UBE3A-ATS-LNA) | OHB Pediatrics Ltd. | 2020 | — | Designated |
Recombinant adeno-associated virus vector containing the active biological substance AAV-GTX-hUBE3A | Recombinant adeno-associated virus vector containing the active biological substance AAV-GTX-hUBE3A | PTC Therapeutics, Inc. | 2020 | — | Designated |
cyclo(-L-Glycyl-L-2-Allylproline) | cyclo(-L-Glycyl-L-2-Allylproline) | Neuren Pharmaceuticals, Ltd. | 2019 | — | Designated |
Chimeric locked nucleic acid and ribonucleic-deoxyribonucleic antisense oligonucleotide specific for the human UBE3A-antisense transcript | Chimeric locked nucleic acid and ribonucleic-deoxyribonucleic antisense oligonucleotide specific for the human UBE3A-antisense transcript | Ultragenyx Pharmaceutical Inc. | 2019 | — | Designated |
[(4-benzylpiperazin-1-yl)(2-(isopentylamino)pyridin-3-yl)methanone]-phosphate | [(4-benzylpiperazin-1-yl)(2-(isopentylamino)pyridin-3-yl)methanone]-phosphate | Seneca Biopharma, Inc. | 2018 | — | Designated |
antisense oligonucleotide specific to the antisense transcript of UBE3A | antisense oligonucleotide specific to the antisense transcript of UBE3A | GeneTx Biotherapeutics, LLC | 2018 | — | Withdrawn |
4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol | 4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol | Healx Limited | 2016 | — | Designated |
recombinant adeno-associated virus serotype 9 vector containing the transgene UBE3A encoding for ubiquitin protein ligase E3A/E6-AP | recombinant adeno-associated virus serotype 9 vector containing the transgene UBE3A encoding for ubiquitin protein ligase E3A/E6-AP | PTC Therapeutics, Inc. | 2015 | — | Designated |
Feeding | Gastroenterology / nutrition / feeding team eval | To incl eval for gastroesophageal reflux nutritional status |
Ophthalmology | Ophthalmology exam | To assess for strabismus, evidence of ocular albinism, visual acuity |
Musculoskeletal | Orthopedics / physical medicine rehabilitation / PT/OT eval | To incl assessment of:; Scoliosis gait impairment (e.g. |
Genetic counseling | By genetics professionals1 | To obtain a pedigree inform affected persons their families re nature, MOI, implications of AS in order to facilitate medical personal decision making Family support/ resources |
Treatment of Manifestations in Individuals with Angelman Syndrome Manifestation/Concern | Treatment | Considerations/Other Seizures |
disturbance | Safe but confining bedrooms to accommodate disruptive nighttime wakefulness | Administration of 0.3 mg melatonin 1 hr before sleep may be helpful, but should not be given in the middle of the night if the child awakens. Socially disruptive or self-injurious |
behaviors | Behavior modification can be effective. | Motor delay |
Source: GeneReviews — "Angelman Syndrome"
Clinical study results | 14 | 5% |
Other research | 4 | 1% |
AI-curated news mentioning Angelman syndrome
Updated Oct 14, 2026
Ultragenyx Pharmaceutical sold two priority review vouchers, each from an FDA approval of a gene therapy. Both therapies came from business deals and proceeds from the voucher sales put Ultragenyx in a better financial position to pursue yet another deal for a rare disease asset. Another voucher came from the mid-September FDA nod for Fayuvi, a gene therapy for a different rare inherited enzyme deficiency called Sanfilippo syndrome Type A. Each product is the first approved therapy for its respective ultra-rare indication. While the Ultragenyx gene therapies carry multi-million-dollar price tags, neither product is expected to become a big revenue driver. Much of the company’s future financial expectations had rested on apazunersen, which was in development for Angelman syndrome, a rare genetic neurological disorder with no FDA-approved therapies. Both therapies came from business deals and proceeds from the voucher sales put Ultragenyx in a better financial position to pursue yet another deal for a rare disease asset. ... Ultragenyx Pharmaceutical recently received two separate FDA approvals for gene therapies in the span of a month, each regulatory nod accompanied by a voucher the company could use to speed up the future review of another rare disease drug. Ultragenyx’s two gene therapies also came from business deals. The capital from the voucher sales could be applied toward another deal for a different rare disease therapeutic candidate. While the company made clear its intent to sell both vouchers, it has not said how it will use the proceeds. In a prepared statement, Chief Financial Officer Howard Horn noted that the Sanfilippo gene therapy benefited from capital generated by a previous voucher sale, “demonstrating the important role the [priority review voucher] program plays in helping companies develop transformative therapies for rare disease patients.”
/PRNewswire/ -- AS2Bio: MavriX Bio, a clinical-stage biotechnology company focused on the development of transformative genetic therapies for Angelman syndrome... 1, 2026 /PRNewswire/ -- AS2Bio: MavriX Bio, a clinical-stage biotechnology company focused on the development of transformative genetic therapies for Angelman syndrome (AS), today announced that the U.S. Food and Drug Administration (FDA) has granted Rare Pediatric Disease Designation (RPDD) to its investigational gene therapy, MVX-220, for the treatment of AS, a rare and debilitating neurogenetic disorder caused by the loss of function of the maternally inherited Ubiquitin Protein Ligase E3A (UBE3A) gene. GEMMABio is a clinical-stage therapeutics company focused on speeding the research of and global access to life-changing advanced therapies for those living with rare diseases. The company conducts research and product development functions to bring gene therapy discoveries from the bench to the bedside faster and affordably. There are no approved treatments for individuals living with AS. Rare Pediatric Disease Designation is granted by the FDA to therapies intended to treat serious or life-threatening diseases that primarily affect individuals from birth through 18 years of age and affect fewer than 200,000 people in the United States. "This designation represents an important milestone in our development program and reinforces our commitment to advancing innovative genetic treatments for individuals living with Angelman syndrome." Developed with funding from the Foundation for Angelman Syndrome Therapeutics (FAST), MVX-220 was advanced by MavriX Bio for clinical development following a research collaboration with Gemma Biotherapeutics.
Ionis Pharmaceuticals secures the first targeted approval for Alexander disease, marking a significant milestone in rare disease treatment. Meanwhile, Novo Nordisk and Novartis face setbacks with late-stage trial cancellations and Phase 3 failures in cardiovascular and muscular dystrophy indications.
Ultragenyx faces a significant setback as its Angelman syndrome therapy fails a key study, prompting the company to consider major cost cuts. This failure impacts the company's financial strategy and highlights the challenges in developing treatments for this rare disease.
Ultragenyx's Phase 3 trial for apazunersen in Angelman syndrome has failed, significantly impacting the company's stock and prompting a strategic review. This setback removes a critical asset that was expected to drive future milestones for the biotech.