Core Viewpoint - Sarepta Therapeutics faces significant challenges following the second death linked to its DMD treatment ELEVIDYS, leading to a suspension of shipments for non-ambulatory patients and a drastic drop in stock price [1][2][4]. Group 1: Sarepta Therapeutics - The recent death of a patient due to acute liver failure after treatment with ELEVIDYS marks a second tragic incident, raising serious concerns about the safety of the drug [1]. - Following the incident, Sarepta suspended shipments of ELEVIDYS for non-ambulatory patients and withdrew its revenue guidance, resulting in a stock price decline of over 42% [2][4]. - ELEVIDYS accounted for 61% of Sarepta's total revenue of $612 million last quarter, with sales growth of 180%, making the suspension a critical blow to the company's financial outlook [5]. - Despite the suspension, only 15% of ELEVIDYS patients have been non-ambulatory, allowing Sarepta to continue selling to the majority of its patient base [6]. - The company is working on an enhanced regimen to mitigate the risk of liver failure, pending FDA approval, with hopes to provide guidance during its Q2 earnings call [7][8]. Group 2: Solid Biosciences - Solid Biosciences, developing a potentially safer alternative to ELEVIDYS called STG-003, saw its shares rise over 11% following Sarepta's news, indicating investor confidence in its prospects [3][10]. - STG-003 has shown high efficacy in early-stage trials, with the highest average microdystrophin expression among DMD gene therapies to date, positioning it as a strong contender in the market [10]. - Liver safety concerns are prevalent in gene therapies, with ELEVIDYS causing elevated liver enzymes in about 30% of patients, while STG-003 appears to be less damaging to the liver [11]. - Solid plans to meet with the FDA in Q4 2025 to discuss the potential for accelerated approval of STG-003, which could expedite its entry into the market [13].