Sarepta Therapeutics is undergoing a significant strategic restructuring following safety concerns related to its Duchenne muscular dystrophy (DMD) gene therapy, Elevidys. The company announced a 36% workforce reduction, impacting approximately 500 employees, aiming to save $400 million annually. This move accompanies a pivot toward siRNA-based therapies and halting development of most gene therapies for limb-girdle muscular dystrophy. The FDA has requested a black box warning on Elevidys due to acute liver injury risks after patient deaths. Sarepta is working on enhanced immunosuppressive regimens to manage these safety issues and plans to submit new protocols for regulatory approval. Financially, the restructuring aims to improve flexibility and meet upcoming debt obligations.