Sarepta Therapeutics is executing a major strategic restructuring in response to safety issues linked to its Duchenne muscular dystrophy gene therapy Elevidys, following two patient deaths from acute liver failure. The company is cutting approximately 500 jobs—36% of its workforce—and pivoting from gene therapies towards siRNA platforms targeting rare genetic diseases. Sarepta has paused dosing in non-ambulatory patients and implemented a black box warning for Elevidys, while seeking FDA approval for enhanced immunosuppression regimens. The cost-saving measures aim to secure financial stability and meet 2027 obligations.