How It Works
Meet Levi, age 10. Amenable to exon 45 skipping

Treatment with AMONDYS 45 (casimersen).

A lack of dystrophin causes muscle cells to become damaged and weakened over time. 
AMONDYS 45 uses exon-skipping technology to allow the body to make a shorter form of the dystrophin protein by skipping over a specific exon on the dystrophin gene.a

aBoys treated with AMONDYS 45 showed varying levels of increased dystrophin production after 48 weeks. In an ongoing clinical study, 27 boys (median age 9 years) receiving AMONDYS 45 had an average dystrophin level of 1.74% of normal, compared to 0.76% in 16 boys who received a placebo infusion.

Amenable

a•me•na•ble

əˈmēnəb(ə)l,əˈmenəb(ə)l/

(of a thing) capable of being acted upon in a particular way; susceptible to.

The Duchenne patients genetic test identified that he had a mutation that could be treated by AMONDYS 45. His doctor said he was amenable to treatment with the exon-skipping therapy.”

What is exon skipping?

Duchenne is caused by a genetic mutation in the dystrophin gene. Most commonly, one or more exons (parts of the gene) are missing, causing errors in the instructions for making dystrophin. This results in the body not being able to produce enough—or any—working dystrophin protein. The goal of exon skipping is to allow the body to make a shorter form of the dystrophin protein.a This video will show you how.

aBoys treated with AMONDYS 45 showed varying levels of increased dystrophin production after 48 weeks. In an ongoing clinical study, 27 boys (median age 9 years) receiving AMONDYS 45 had an average dystrophin level of 1.74% of normal, compared to 0.76% in 16 boys who received a placebo infusion.

How exon skipping works.

Understanding the dystrophin gene.


The dystrophin gene is made up of exons (portions of a gene) that are linked together to provide instructions for making dystrophin—a protein our muscles need to work properly. Without dystrophin, muscle cells become damaged and weaken over time.

Graphic of a dystrophin gene

How exons connect.


With 79 exons, the dystrophin gene is the largest in the body. Think of the exons on the dystrophin gene like toy train cars, each with a special connection that allows one car to connect to another. In order for all the cars to move together as a train, the connections between cars must match—for example, circle-to-circle and square-to-square.

Graphic of train cars representing exons in the dystrophin gene

When an exon is missing.


Here we can see that car 44—or exon 44—is missing. The result is that cars 43 and 45 are not able to connect because their connectors are different shapes and don’t fit together. In the dystrophin gene, this missing exon would prevent the body from being able to read the instructions for making the dystrophin protein.

Graphic of train cars representing exons in the dystrophin gene with exon 44 missing

Skipping over exons.


By moving certain exons—or cars—aside, we can “skip over” them to find a car with the right connector. The new train would be shorter, but the cars are connected. Just as we skipped over a train car, AMONDYS 45 is designed to skip over an exon.

 

Graphic of train cars representing exons in the dystrophin gene with exon 45 skipped

The result: A shorter form of dystrophin.


AMONDYS 45 works using exon-skipping technology. Weekly infusions with AMONDYS 45 have been shown to help the body make a shorter form of the dystrophin protein.a Watch the video.

aBoys treated with AMONDYS 45 showed varying levels of increased dystrophin production after 48 weeks. In an ongoing clinical study, 27 boys (median age 9 years) receiving AMONDYS 45 had an average dystrophin level of 1.74% of normal, compared to 0.76% in 16 boys who received a placebo infusion.

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Graphic of train cars representing exons in the dystrophin gene, with exon 43 and 46 highlighted
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Related FAQs

Has AMONDYS 45 been tested?

Yes. AMONDYS 45 is being studied in an ongoing clinical trial. See clinical trial results.

Who can take AMONDYS 45?

Duchenne patients who receive AMONDYS 45 must have a genetic test that shows a mutation in the dystrophin gene that can be treated by skipping exon 45. Your child's doctor is best equipped to determine if your child’s mutation is amenable to treatment with AMONDYS 45. We’ve developed a Doctor Discussion Guide to help you start that important conversation.

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What is AMONDYS 45 (casimersen)?

AMONDYS 45 is used to treat patients with Duchenne muscular dystrophy (DMD) who have a confirmed mutation of the dystrophin gene that can be treated by skipping exon 45.

This indication is approved under accelerated approval based on an increase in dystrophin production in skeletal muscle observed in patients treated with AMONDYS 45. Continued approval for this indication may be contingent upon verification of a clinical benefit in confirmatory trials.

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IMPORTANT SAFETY INFORMATION

Contraindications: Do not receive AMONDYS 45 if you are allergic to casimersen or any of the ingredients in AMONDYS 45. Serious allergic reactions to casimersen have included anaphylaxis, which may include difficulty breathing, tightness in the chest, and angioedema which may include swelling of the mouth, face, lips, or tongue.

Hypersensitivity Reactions: Serious allergic reactions, including angioedema and anaphylaxis, have occurred in patients who were treated with AMONDYS 45. Patients should seek immediate medical care should they experience signs and symptoms of allergic reactions. Your doctor will institute appropriate medical treatment which may include slowing, interrupting, or discontinuing the AMONDYS 45 infusion. Your doctor will monitor you until the condition resolves.

Kidney Toxicity and Monitoring: Damage to the kidneys was seen in animals who received casimersen. Although damage to the kidneys was not seen in clinical studies with AMONDYS 45, potentially fatal kidney damage has occurred with other drugs that work in a similar way. Your doctor may recommend urine and blood testing before starting treatment followed by urine testing every month and a blood test every 3 months to monitor your kidneys.

Adverse Reactions: Side effects occurring in at least 20% of patients treated with AMONDYS 45 and at least 5% more frequently than in patients who received an inactive intravenous (IV) infusion were (AMONDYS 45, placebo): upper respiratory tract infection (65%, 55%), cough (33%, 26%), fever (33%, 23%), headache (32%, 19%), joint pain (21%, 10%), and pain in mouth and throat (21%, 7%).

Other side effects that occurred in at least 10% of patients treated with AMONDYS 45 and at least 5% more frequently than patients who received an inactive IV infusion were: ear pain, nausea, ear infection, pain after injury, and dizziness and light-headedness.

What do I do if I have side effects?

Ask your healthcare provider for advice about any side effects that concern you.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report side effects to Sarepta Therapeutics at 1-888-SAREPTA (1-888-727-3782).

The information provided here does not include all that is known about AMONDYS 45. To learn more, talk with your healthcare provider.

Before receiving this infusion, please see the full Prescribing Information for AMONDYS 45 (casimersen).