Sarepta Therapeutics is refusing to pull its gene therapy Elevidys (delandistrogene moxeparvovec), despite a request from the US Food and Drug Administration (FDA).
Speaking on 18 July, shortly after the FDA ordered the pull for Elevidys, Sarepta said it will continue to ship Elevidys to the ambulant population as studies show no signs of new or changed safety signals, adding it first heard of this potential request earlier in the day through media reports.
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A statement from the company reads: “At Sarepta, patient safety and well-being are always our top priority. We are committed to upholding the highest safety standards for all of our therapies.
“This guides every decision we make, as evidenced by our conservative decision to pause shipments of Elevidys for non-ambulant patients while we work with the FDA to update the label and evaluate the use of an enhanced immunosuppression regimen to mitigate the risk of acute liver failure (ALF).”
Trial of LGMD therapy also put on hold
The FDA has also put a hold on Sarepta’s gene therapy SRP-9004 in limb girdle muscular dystrophy (LGMD) after a patient died in an early-stage study due to ALF.
Speaking about the patient death in the Phase I trial of SRP-9004, the company’s statement added: “We recognise that the death of any patient is heartbreaking, including the recent death of a 51-year-old non-ambulant LGMD patient.
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By GlobalData“We also want to clarify that this tragic event occurred in a Phase I clinical trial for an investigational gene therapy called SRP-9004. SRP-9004 is a clinical-stage therapy that is intended to treat a different disease, is administered using a different dose, and is manufactured using a different process. The LGMD study participant who passed away was not treated with Elevidys, and the dosing for the SRP-9004 trial had concluded at the time of his death.”
This patient’s death, which was reported to the FDA on 3 July, is the third that has impacted Sarepta’s gene therapy programme, with the first two deaths earlier this year in patients treated with Elevidys, both also due to ALF. Both Elevidys and SRP-9004 are adeno-associated virus (AAV) gene therapies that use the same AAVrh74 serotype.
The FDA’s Center for Biologics Evaluation and Research (CBER) director Dr Vinay Prasad, said: “Protecting patient safety is our highest priority, and the FDA will not allow products whose harms are greater than benefits. The FDA will halt any clinical trial of an investigational product if clinical trial participants would be exposed to an unreasonable and significant risk of illness or injury.”
This comes just days after Sarepta said it has agreed to change the black box on the Elevidys label to include ALF and acute liver injury (ALI) warnings. In the same announcement, Sarepta said it would be cutting 500 jobs as part of company restructuring.
Speaking after the third patient death was announced, GlobalData healthcare analyst Momna Ali said the recent setbacks for Sarepta put the cell and gene therapy (CGT) sector at a “crossroads”.
Ali said: “Following Sarepta’s announcement of a third patient death, a new label for Elevidys and them laying off 500 employees, or 36% of its workforce, shelving parts of its pipeline to save $420m, and shifting focus from gene therapy to siRNA programmes, this is going to put the CGT sector at a pivotal crossroad.
“While the scientific potential of CGT therapies remains extraordinary, this moment serves as a reminder of the complexity, cost, and responsibility involved. There is a lot of buzz around therapies ‘beyond the pill’; however, for the landscape to keep evolving at the pace it has been in the last 3-5 years, there has to be greater transparency, patient safety, and sustainable innovation – otherwise, it’ll be met with more setbacks.”
The news of the LGMD death came to light on 17 July in media reports. After this was reported, Sarepta’s stock has dropped 43.21%, from $22.54 at market open on 17 July to $12.80 at market open on 21 July.
The FDA also said it has revoked the platform technology designation for Sarepta’s AAVrh74 Platform Technology.
