SRPT Plummets on Second Patient Death After DMD Gene Therapy Infusion

Core Insights - Sarepta Therapeutics' shares fell 42% in pre-market trading following the report of a second patient death linked to its gene therapy Elevidys for Duchenne muscular dystrophy (DMD) [1] - The second fatality was due to acute liver failure, mirroring the cause of the first death reported three months prior, both involving non-ambulatory DMD patients [1][2] Company Developments - In response to the recent fatalities, Sarepta has suspended Elevidys dosing for non-ambulatory patients in commercial settings and is considering an enhanced immunosuppression regimen to improve safety [2] - The company has also paused dosing in the late-stage ENVISION study, which is crucial for regulatory approval of Elevidys outside the United States [2][3] - Despite these setbacks, Sarepta maintains that Elevidys' benefit-risk profile remains positive for ambulatory patients, and the company has communicated these developments to the FDA and other global health authorities [3] Financial Impact - The timing of the second death is particularly detrimental as Sarepta's shares have already decreased by 70% year-to-date, compared to a 1% decline in the industry [4][5] - Elevidys is a significant revenue source for Sarepta, accounting for over half of the company's revenue in Q1 2025, with sales reaching approximately $821 million in 2024, up from $200 million the previous year [7][9] - Following the first fatality, the European Medicines Agency (EMA) placed a clinical hold on Elevidys-related studies, impacting the therapy's launch plans in Europe and forcing Sarepta to lower its full-year 2025 revenue guidance from $2.9-$3.1 billion to $2.3-$2.6 billion [8][9] Product Overview - Elevidys is the first and only one-time gene therapy for DMD approved in the United States, currently authorized for individuals aged four years and older, regardless of ambulation status [10] - The therapy has received full approval for ambulatory DMD patients but only accelerated approval for non-ambulatory patients, with the ENVISION study serving as the confirmatory trial for full approval [10] - Sarepta developed Elevidys in partnership with Roche, which holds exclusive rights to market the therapy in non-U.S. markets [11]