Sarepta Therapeutics has initiated a significant restructuring after safety issues emerged with its Duchenne muscular dystrophy gene therapy Elevidys, including two patient deaths from acute liver failure. The company is laying off approximately 500 employees, about 36% of its workforce, and pivoting its research focus towards siRNA therapies for rare genetic diseases. Sarepta is working on an enhanced immunosuppressive regimen for non-ambulatory patients and plans to submit the proposed protocol to the FDA. The FDA has requested a black box warning for Elevidys due to acute liver injury risks. Sarepta's stock rose more than 50% after the announcement, reflecting investor approval of the cost-cutting move despite clinical setbacks.