The market for large molecule biological drugs has grown rapidly, including antisense oligonucleotide (ASO) drugs. ASO drugs work as single-stranded synthetic oligonucleotides that reduce production or alter functions of disease-causing proteins through various mechanisms, such as mRNA degradation, exon skipping, and ASOprotein interactions. After the first ASO drug Fomivirsen was approved in 1998, the US Food and Drug Administration has approved 10 ASO drugs to date. Although ASO drugs are efficacious in treating some diseases that are untargetable by small-molecule chemical drugs, concerns on adverse drug reactions (ADRs) and toxicity cannot be ignored. Illustrative of this, Mipomersen was recently taken off the market due to its hepatotoxicity risk. This paper reviews ADRs and toxicity from FDA drug labeling, preclinical studies, clinical trials, and post-marketing real-world studies on the ten FDAapproved ASO drugs, including Fomivirsen and Pegaptanib Mipomersen, Nusinersen, Inotersen, Defibrotide, Eteplirsen, Golodirsen, Viltolarsen, and Casimersen. Unique and common ADRs and toxicity for each ASO drug are summarized here. The risk of developing hepatotoxicity, kidney toxicity, and hypersensitivity reactions co-exists for multiple ASO drugs. Special precautions need to be in place when certain ASO drugs are administrated. Further discussion is extended on studying the mechanisms of ADRs and toxicity of these drugs, evaluating the existing physiological and pathological states of patients, optimizing the dose and route of administration, and formulating personalized treatment plans to improve the clinical utility of FDA-approved ASO drugs and discovery and development of new ASO drugs with reduced ADRs.

People with mental distress are increasingly turning to one-to-one synchronous communication websites to receive peer support from other members. Though some research has identified benefits and challenges of online peer-support, there is a limited understanding of how to best prepare and scaffold for untrained peer supporters as they attempt to become skillful in an online setting. We recruited 30 (15 pairs) participants to engage in an online support conversation about procrastination problems, gave one member of each pair minimal training in the principles and strategies of motivational interviewing, and used interviews and conversation transcripts to examine challenges novice helpers faced when providing support and learning new conversational skills. We presented the helpers with two conversation goals to achieve with the conversation: building understanding, and promoting readiness for change. The research identified the common strategies the helpers used to achieve these goals and the challenges they faced. We also discuss theoretical and design implications for platform designers to better scaffold this experience.CCS Concepts: • Human-centered computing → Empirical studies in collaborative and social computing; • Applied computing → Psychology.

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