- Q4 revenue of $442.9 million topped estimates, but adjusted loss per share of $3.58 missed forecasts sharply.
- The company guided 2026 net product revenue to $1.2 billion to $1.4 billion, skewed toward the low end without an education-driven recovery.
- PMO therapies remained stable despite Elevidys' “cannibalization”, generating $259.2 million in Q4.
Shares of Sarepta Therapeutics Inc. (SRPT) slid nearly 4% in extended trading on Wednesday as investors looked past a revenue beat and focused on a steep quarterly loss, Elevidys disruption, and a looming CEO transition.
SRPT stock rose 0.7% in Wednesday’s regular session, marking its second consecutive session of gains, as traders expected stronger earnings.
Elevidys Hit Weighs On SRPT Q4 Revenue
Sarepta reported fourth-quarter (Q4) revenue of $442.9 million, exceeding consensus expectations of $390.95 million. However, the biotech firm posted an adjusted loss per share of $3.58, significantly wider than analysts’ expectations of a $0.77 loss.
Total revenue declined from $658.4 million in the prior-year quarter, dragged down by a $273.8 million reduction in Elevidys net product revenue, following the company's June 2025 suspension of shipments to patients who cannot walk in the U.S.
For the full year 2025, net product revenue totaled $1.86 billion, including $965.6 million from its PMO (phosphorodiamidate morpholino oligomer), which are exon-skipping therapies for Duchenne muscular dystrophy (DMD), and $898.7 million from Elevidys.
Cost of sales also rose to $398.7 million, driven largely by a $165.3 million inventory valuation reserve tied to excess Elevidys and PMO inventory, product batch write-offs and manufacturing-related charges.
Sarepta CEO Doug Ingram To Retire By This Year
CEO Doug Ingram said he plans to retire around the end of 2026, after nearly 9 years leading the company. He said that the decision was due to family commitments, noting that two members of his immediate family were recently diagnosed with myotonic dystrophy type 1, or DM1.
“This decision was a deeply difficult one for me as this is the most meaningful and rewarding role that one could imagine, and we stand at one of the most exciting moments in our entire history,” Ingram said on the earnings call.
The board has begun a comprehensive search for his successor, considering both internal and external candidates.
Elevidys Enters ‘Reset Year’ After Safety Concerns
In November 2025, the U.S. Food and Drug Administration (FDA) approved updated prescribing information for Elevidys that added a boxed warning for serious liver injury, removed the non-ambulatory indication, and expanded immunosuppression and monitoring guidance. The therapy now holds traditional approval for ambulatory patients aged four and older.
“The safety events of 2025 reshaped the perceptions of gene therapy and of Elevydis specifically. As a result, it has become more clear to us that 2026 serves as a critical reset year for the ambulatory patient population,” chief commercial officer Patrick Moss said on the earnings call.
On the earnings call, the company acknowledged that the temporary shipment suspension created hesitation among physicians and families, contributing to an “information imbalance” regarding the therapy’s risk-benefit profile.
The company said it will implement educational and commercial outreach initiatives to provide physicians and caregivers with clearer data and guidance. However, the company added that “given the timing of the initiatives and the long cycle time for Elevidys, we do not expect that we will begin to see the impact of our educational efforts until at least well into the second half of this year.”
Elevidys’ Q4 revenue was also affected by a severe flu season and six planned infusions that were rescheduled into 2026. While Sarepta guided to 2026 net product revenue of $1.2 billion to $1.4 billion, the company said that without the impact of expanded education efforts, revenue would likely track toward the lower end of that range.
PMO Franchise Holds Steady Despite Elevidys Shift
Sarepta said its three (PMO) therapies “have remained stable even in the face of Elevidys cannibalization.”
It reiterated that it had long expected some degree of patient transition to gene therapy but said the PMO portfolio continues to show durability, supported by strong physician backing and compliance rates above 90%.
The company also said it is seeing more dual use than initially anticipated, with some physicians keeping patients on PMOs alongside Elevidys in certain cases, and noted that a small number of patients have returned to PMO therapy after gene treatment.
Q4 PMO net product revenue totaled $259.2 million, which the company said was “relatively stable” compared to the previous year despite the gene therapy shift.
3-Year Results Bolster Gene Therapy Outlook
Sarepta highlighted positive three-year results from the Phase 3 Embark study evaluating Elevidys.
Three years after treatment, patients who received Elevidys remained above baseline on a standard motor function scale, whereas comparable untreated patients showed the expected decline. At the third-year mark, the therapy slowed disease progression by 73% on the time-to-rise test and 70% on the 10-meter walk/run test versus controls, with the gap between groups widening from the second to the third year. Over 1,200 patients have received Elevidys in trials and commercial use.
Cohort 8 Aims To Reopen Non-Walking Market
Sarepta is seeking a pathway back to the DMD population that cannot walk through Endeavor Cohort 8, which will test a stronger immune-suppressing approach, including the drug sirolimus, as part of the Elevidys treatment plan.
The FDA approved dosing in Cohort 8 in November 2025, with nearly 25 U.S. patients who cannot walk expected to enroll. The study will assess dystrophin expression and incidence of acute liver injury, with data anticipated by the end of 2026.
The company said results are intended to inform future regulatory discussions regarding the potential expansion of Elevidys' use in patients who cannot walk.
How Did Stocktwits Users React?
On Stocktwits, retail sentiment for SRPT was ‘extremely bullish’ amid ‘high’ message volume.
One user questioned, “Anyone think Doug may be retiring b/c he realizes this will be a non-stop struggle just to keep head above water?”
Another user said, “This is a $100 stock halved three separate times last year during after hours and premarket. Any potential buyout with change in CEO needs to approach this level.”
SRPT stock has declined 12% year to date.
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