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.vn-container{-webkit-box-align:center;-ms-flex-align:center;align-items:center;display:-webkit-box;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-ms-flex-pack:justify;justify-content:space-between;height:3rem;margin:0 auto;max-width:77.5rem;z-index:1}@media(min-width:64.0625rem){.vn-wrapper .vn-container{height:4.6875rem}}.vn-wrapper .vn-container.lite{max-width:100%}@media(min-width:64.0625rem){.vn-wrapper .vn-container.lite{height:3.5rem}}.vn-wrapper .vn-menu-btn{-webkit-box-align:center;-ms-flex-align:center;align-items:center;background:none;border:0;color:#fff;cursor:pointer;display:-webkit-box;display:-ms-flexbox;display:flex;height:100%;line-height:1;padding:0}.vn-wrapper .vn-menu-btn:not(.lite){margin-right:1.166875rem}@media(min-width:64.0625rem){.vn-wrapper .vn-menu-btn:not(.lite){margin-right:0}}.vn-wrapper .vn-menu-btn i{font-size:2.25rem;width:2.25rem;overflow:hidden}.vn-wrapper .vn-menu-btn svg{fill:currentColor;pointer-events:none}.vn-wrapper .vn-menu-btn.vn-search i{font-size:1.875rem;width:1.875rem}.vn-wrapper .vn-menu-btn.vn-search:not(.lite){margin-right:0}@media(min-width:64.0625rem){.vn-wrapper .vn-menu-btn.vn-search:not(.lite) i{font-size:1.625rem;width:1.625rem}}.vn-wrapper .vn-menu-btn.vn-search.lite i{font-size:2rem;width:2rem}.vn-wrapper .vn-logo-container{-webkit-box-align:center;-ms-flex-align:center;align-items:center;display:-webkit-box;display:-ms-flexbox;display:flex}.vn-wrapper .vn-logo-container .vn-logo-div{height:.9375rem;margin:0 .625rem}@media(min-width:64.0625rem){.vn-wrapper .vn-logo-container .vn-logo-div{height:1.5625rem;margin:0 1.25rem}}.vn-wrapper .vn-logo-container .vn-logo,.vn-wrapper .vn-logo-container .vn-prog-logo{line-height:1}.vn-wrapper .vn-logo-container .vn-logo img,.vn-wrapper .vn-logo-container .vn-prog-logo img{display:block;height:1.3125rem}@media(min-width:64.0625rem){.vn-wrapper .vn-logo-container .vn-logo img,.vn-wrapper .vn-logo-container .vn-prog-logo 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i{font-size:.625rem;margin-left:.3125rem;-webkit-transition:transform .3s ease;transition:transform .3s ease}.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:hover>a{background:#fff;color:#00157c}.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:hover>a i{-webkit-transform:rotate(180deg);transform:rotate(180deg)}.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:hover .vn-menu-section{left:0;opacity:1;visibility:visible}.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:focus-visible>a,.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:has(:focus-visible)>a{background:#fff;color:#1b1b1b}.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:focus-visible>a i,.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:has(:focus-visible)>a i{-webkit-transform:rotateX(180deg);transform:rotateX(180deg)}.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:focus-visible .vn-menu-section,.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:has(:focus-visible) .vn-menu-section{left:0;opacity:1;visibility:visible}}@media(min-width:81.25rem){.vn-wrapper .vn-links .vn-links-list:not(.lite)>li:not(:nth-child(7)){margin-right:1rem}}.vn-wrapper .vn-links .vn-menu-section{background:#f9f9fc;height:calc(100vh - 3rem);right:-140vw;overflow:auto;padding:0 1.5rem 6.25rem 1.5rem;position:fixed;top:3rem;-webkit-transition:all .5s ease;transition:all .5s ease;width:100%;z-index:10}.vn-wrapper .vn-links .vn-menu-section.lite{height:calc(100vh - 3.5rem);top:3.5rem}@media(min-width:37.5rem){.vn-wrapper .vn-links .vn-menu-section{max-width:25rem;left:-140vw;right:auto}.vn-wrapper .vn-links .vn-menu-section.open{left:0;right:auto}}.vn-wrapper .vn-links .vn-menu-section.open{right:0}.vn-wrapper .vn-links .vn-menu-section .vn-menu-section-header{-webkit-box-align:center;-ms-flex-align:center;align-items:center;border-bottom:1px solid #c6cedb;display:-webkit-box;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-ms-flex-pack:justify;justify-content:space-between;padding:.75rem 0}.vn-wrapper .vn-links .vn-menu-section .vn-menu-section-header .nav-title{color:#1b1b1b;font-size:1.25rem;line-height:1;margin:0}.vn-wrapper .vn-links .vn-menu-section .vn-menu-section-header a{color:#3557ff;font-weight:400;text-decoration:none}.vn-wrapper .vn-links .vn-menu-section .vn-menu-section-header a img{margin-right:.5rem;width:.8125rem}.vn-wrapper .vn-links .vn-menu-section ul{margin:.75rem 0;list-style:none;padding:0}.vn-wrapper .vn-links .vn-menu-section ul li{font-size:1.125rem;font-weight:400}.vn-wrapper .vn-links .vn-menu-section ul li a{color:#1b1b1b;display:block;padding:.75rem 0;text-decoration:none}.vn-wrapper .vn-links .vn-menu-section ul li a:hover{color:#3557ff}.vn-wrapper .vn-links .vn-menu-section ul li hr{border:1px solid #c6cedb}@media(min-width:64.0625rem){.vn-wrapper .vn-links .vn-menu-section:not(.lite){background:#fff;border-radius:0 0 5px 5px;border-top:0;left:-20px;margin-left:-3.75rem;max-width:none;height:auto;opacity:0;padding:1.875rem 2.875rem;position:absolute;top:4.6875rem;width:18.75rem;visibility:hidden}.vn-wrapper .vn-links .vn-menu-section:not(.lite) hr{display:none}.vn-wrapper .vn-links .vn-menu-section:not(.lite) ul{margin:0}.vn-wrapper .vn-links .vn-menu-section:not(.lite) ul li{border-bottom:1px solid #c6cedb}.vn-wrapper .vn-links .vn-menu-section:not(.lite) ul li:last-of-type{border-bottom:0}.vn-wrapper .vn-links .vn-menu-section:not(.lite) ul li.vn-see-all a{-webkit-box-align:baseline;-ms-flex-align:baseline;align-items:baseline;color:#3557ff;display:-webkit-box;display:-ms-flexbox;display:flex;-webkit-box-pack:start;-ms-flex-pack:start;justify-content:flex-start}.vn-wrapper .vn-links .vn-menu-section:not(.lite) ul li.vn-see-all a img{height:.75rem;margin-right:.5rem}.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-1{width:60.9375rem}.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-1 ul{-webkit-columns:4;-moz-columns:4;columns:4;-webkit-column-gap:2.875rem;-moz-column-gap:2.875rem;column-gap:2.875rem}.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-1 ul li:nth-child(7),.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-1 ul li:nth-child(14),.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-1 ul li:nth-child(21){border-bottom:0}.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-3{width:35rem}.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-3 ul{-webkit-columns:2;-moz-columns:2;columns:2;-webkit-column-gap:2.875rem;-moz-column-gap:2.875rem;column-gap:2.875rem}.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-3 ul li:nth-child(8),.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-3 ul li:nth-child(16){border-bottom:0}}@media(min-width:64.0625rem)and (max-width:81.25rem){.vn-wrapper .vn-links .vn-menu-section:not(.lite).hdr-site-1{margin-left:-8.75rem}}.vn-wrapper .vn-links .vn-back{-webkit-box-align:center;-ms-flex-align:center;align-items:center;background:none;border:0;color:#3557ff;cursor:pointer;display:-webkit-box;display:-ms-flexbox;display:flex;padding:1rem 0}.vn-wrapper .vn-links .vn-back i{font-size:.75rem;margin-right:.3125rem}.vn-wrapper .vn-links .vn-actions{margin-top:1rem}@media(min-width:64.0625rem){.vn-wrapper .vn-links .vn-actions:not(.lite){-webkit-box-align:center;-ms-flex-align:center;align-items:center;border-left:1px solid #cccce7;display:-webkit-box;display:-ms-flexbox;display:flex;margin:1.1875rem 0;padding-left:1.25rem}}@media(min-width:64.0625rem){.vn-wrapper .vn-links .vn-actions:not(.lite).no-subscribe{border-left:none}}.vn-wrapper .vn-links .vn-actions:not(.lite).no-subscribe .vn-signin{padding-left:.9375rem}@media(min-width:64.0625rem){.vn-wrapper .vn-links .vn-actions:not(.lite).no-subscribe .vn-signin{padding-left:0}}.vn-wrapper .vn-links 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Erowele, MBA, PharmD"},"about":"Childhood Genetic Diseases (Sensitive Topic)","datePublished":"08/15/2024 09:57:35","headline":"Your Guide to Elevidys for Duchenne Muscular Dystrophy","author":{"@type":"Person","name":"Kelli Garrison, PharmD, BCPS"},"dateModified":"08/06/2024 00:00:00","publisher":{"@type":"Organization","name":"WebMD","logo":{"@type":"ImageObject","url":"https://img.lb.wbmdstatic.com/vim/live/webmd/consumer_assets/site_images/logos/webmd/web/webmd_logo_53x12.gif"}}}</script><div class="inner-article-container"><header><h1>Your Guide to Elevidys for Duchenne Muscular Dystrophy</h1></header><div class="med-wrap"><div><div class="asset-med-rev"><div class="reviewer-info" data-chronicle="091e9c5e81e48710" data-e2e="asset-medical-review" data-metrics-module="rvdby-lnk"><span class="reviewer-photo-cont"><figure><img src="https://img.lb.wbmdstatic.com/vim/live/webmd/consumer_assets/site_images/articles/biographies/Goldina_Erowele_382x382.jpg?resize=51px:51px&output-quality=75" class="reviewer-photo"></figure></span><span class="reviewer-txt seperatorLine">Medically Reviewed by <a class="person" href="https://www.webmd.com/bio/goldina-erowele" data-metrics-link="0">Goldina I. Erowele, MBA, PharmD</a><span class="no-link"></span><span class="revDate"> on August 06, 2024</span></span></div><div class="byline"><span><span class="authors" data-metrics-module="wrtnby-lnk">Written by <a href="https://www.webmd.com/bio/kelli-garrison" class="person" data-metrics-link="0">Kelli Garrison, PharmD, BCPS</a></span></span></div></div></div></div><aside class="oncology-article-nav" data-metrics-module="cwnav-art"><ul class="nav-items desktop"><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-1-2">How Does Elevidys Work?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-1-4">How Should I Use This Medicine?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-2-5">How Was It Studied for DMD? </a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-3-7">What Benefits Were Seen in the Studies?</a><div class="item-button"><a href="#"></a></div></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-3-9">When Will the Medicine Start Working?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-4-10">Are There Reasons This Medicine Should Not Be Used?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-4-11">How Can I Prevent and Manage Side Effects?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-5-12">What Monitoring or Blood Tests Might I Need?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-5-14">What Types of Interactions Can Happen?</a></li><li><a href="#0a6b611b-e358-4624-b08f-47dd31d381de-6-15">Getting Your Medicine: What to Expect</a></li><li class="item-button"></li></ul></aside><div class="reading-wrapper"><div class="readtime"><span>10 min read</span></div><div id="audio-placeholder-0a6b611b-e358-4624-b08f-47dd31d381de"></div></div><div class="article__body" data-metrics-module="embd-lnk"><div class="article-page active-page" data-page="1"><section><p dir="ltr"><a href="https://www.webmd.com/children/duchenne-muscular-dystrophy"><span>Duchenne muscular dystrophy</span></a><span> (DMD) is a genetic disease that causes progressive muscle weakness. DMD commonly affects boys, where symptoms are seen in early childhood. There is no cure for DMD. Health care providers manage symptoms with steroids, physical therapy, and assistive devices (like braces, wheelchairs). New medicines are being studied to help slow the progression of DMD by targeting the abnormal gene. </span><a href="https://www.webmd.com/drugs/2/drug-186998/elevidys-intravenous/details"><span>Elevidys</span></a><span> is a new gene therapy medicine for DMD that helps keep muscles strong. </span></p></section><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-1-2">How Does Elevidys Work?</h2><p dir="ltr"><span>Muscles in the body need a protein called dystrophin to work correctly and stay strong. DMD is caused by a genetic mutation that causes the body to make this protein wrong. A mutation is a mistake in the instructions the body uses to make things. Without enough dystrophin, muscles weaken over time. The weakness starts in the legs and pelvis. This makes it hard to run, climb stairs, or get up off the floor. As time goes on, DMD can affect your arms, heart, and lungs. </span></p></section><section> <p dir="ltr"><span>DMD is a progressive disease that is usually diagnosed in young children. This means that the symptoms are more noticeable as the child gets older. Since there is no cure for DMD, health care providers manage the symptoms with medicines and physical therapy to help keep muscles strong. </span></p><p dir="ltr"><span>New medicines have been approved to target specific areas of these genetic mistakes or to provide a similar dystrophin protein directly to the muscle cells. This allows the body to start making a similar dystrophin protein. With more dystrophin, the muscles can stay strong longer. </span></p><p dir="ltr"><span>Elevidys is one of these medicines, also called gene therapy. Elevidys uses a special virus, called a vector, to get a version of the dystrophin protein to the muscle cells. It helps the body produce a shortened version of the dystrophin protein, potentially slowing the progression of the disease.</span></p></section><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-1-4">How Should I Use This Medicine?</h2><p dir="ltr"><span>Elevidys is a single, one-time treatment. It is given as an infusion by a health care provider, which means it is delivered directly into the bloodstream through a vein. The infusion is given at a hospital so that you can be monitored closely. The infusion process can take a few hours. Before the infusion, your health care provider may do blood tests to make sure you are ready for the infusion. (See the Monitoring section below.) </span></p><p dir="ltr"><span>Your health care provider will start a medicine known as a corticosteroid to help prevent infusion-related side effects. Your vaccines should be up-to-date before starting Elevydis. (See the Interaction section below.) Your health care provider will tell you how to take the medicine and when to stop taking it. </span></p></section></div><div class="article-page " data-page="2"><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-2-5">How Was It Studied for DMD? </h2><p dir="ltr"><span>Three studies have been done to look at the safety and efficacy of Elevidys for the treatment of DMD. Two studies (study 1 and study 3) were placebo-controlled, which helps researchers see differences in benefit or harm of a medicine when compared with no treatment. People in the study had a diagnosis of DMD with specific gene mutations. The following information was similar for all the studies.</span></p><ul><li dir="ltr" aria-level="1"><span>Patients were male (100%) and were 4 to 8 years of age, with an average age of 6 years and average weight of 50 pounds.</span></li><li dir="ltr" aria-level="1"><span>Most people receiving Elevidys in the studies were White (76%), with 12% who identified as Asian, 7% as other, 2% as African American or Black, 2% as "not reported," and 1% as multiple races. All people in the study took a corticosteroid medicine before getting the infusion and had antibody levels below the level determined to be safer for Elevidys infusion.</span></li></ul><p dir="ltr"><span>Study 1 had two phases, where people received one infusion of either Elevidys or placebo. The placebo infusion did not have active medicine. The people were monitored for improvements and side effects for 48 weeks. After the first 48 weeks, people in the study switched to receiving either Elevidys or placebo, the opposite of what they received in the first phase. (See the table below.) All of the people in the study were ambulatory, meaning they were able to walk without assistance. </span></p><div dir="ltr" align="left"><table><tbody><tr><td><p dir="ltr"><span>Study Group</span></p></td><td><p dir="ltr"><span>Phase 1: 48 Weeks</span></p></td><td><p dir="ltr"><span>Phase 2: 48 Weeks</span></p></td></tr><tr><td><p dir="ltr"><span>Group 1</span></p></td><td><p dir="ltr"><span>Elevidys</span></p></td><td><p dir="ltr"><span>Placebo</span></p></td></tr><tr><td><p dir="ltr"><span>Group 2</span></p></td><td><p dir="ltr"><span>Placebo </span></p></td><td><p dir="ltr"><span>Elevidys</span></p></td></tr></tbody></table></div></section><section><pagebreak /> <p dir="ltr"><span>In study 2, all people in the study received Elevidys. There was no placebo. A small number of people (17%) were non-ambulatory, meaning they were no longer able to walk independently. </span></p><p dir="ltr"><span>In study 3, people in the study received either an Elevidys or placebo infusion. </span></p><p dir="ltr"><span>The effectiveness of Elevidys in the studies was based on changes in the North Star Ambulatory Assessment (NSAA) score and/or changes in the amount of micro-dystrophin proteins in the skeletal muscles. NSAA is a test that measures how well someone with DMD can move and do their everyday activities. The maximum score is 34. A lower score shows that a person has limited mobility or poor muscle health. The average NSAA score in all studies was 21-23, which means that the person had some limitations in their movement, but they were still able to do most daily activities. Other results looked at the ability to move by timing events like walking/running a distance, climbing four stairs, and standing from lying down. </span></p></section></div><div class="article-page " data-page="3"><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-3-7">What Benefits Were Seen in the Studies?</h2><p dir="ltr"><span>People who received Elevidys in the studies saw improvements in NSAA scores, increases in the amount of dystrophin in their muscles, and positive changes in their timed movements. This means that their muscles were a little stronger and they had more ability to move compared to the people who received a placebo. </span></p><p dir="ltr"><span>Change in NSAA scores. At the end of the studies, people who received Elevidys had an average improvement in their NSAA scores by 2 points compared with a small decrease in scores for the people who received placebo. This means that Elevidys strengthened their muscles, allowing easier movement in their daily activities. The change in scores were greater in younger children who received Elevidys (ages 4-7).</span></p><p dir="ltr"><span>Change in dystrophin proteins. Elevidys delivers a version of the dystrophin protein, which causes the body to start making natural dystrophin. In two studies, the amount of dystrophin in the muscle cells increased. The levels were like what is expected for normal muscles. This could mean that having more dystrophin in the muscle cells could protect the muscles from further damage. Further studies are needed to see how long this effect would last. </span></p></section><section><pagebreak /> <p dir="ltr"><span>Ability to move. In the studies, the mobility of each person was timed when they were doing the following three activities.</span></p><ul><li dir="ltr" aria-level="1"><span>Time to rise, which is the time it takes the person to move from lying down to standing</span></li><li dir="ltr" aria-level="1"><span>Time to walk/run 10 meters and 100 meters</span></li><li dir="ltr" aria-level="1"><span>Time to climb four stairs</span></li></ul><p dir="ltr"><span>The studies showed that people who received Elevidys had improvements in the timing of these activities compared with the people who received placebo. Patients receiving Elevidys were able to complete these movements slightly faster. Further studies are needed to see how long this effect would last. </span></p><p dir="ltr"><span>Your results may differ from what was seen in clinical studies. You and your health care provider should determine if the benefits outweigh any potential risks. </span></p></section><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-3-9">When Will the Medicine Start Working?</h2><p dir="ltr"><span>It may take up to a few years to see the benefits from Elevidys. As the body starts to make its own dystrophin for muscles, the muscles may slowly start to become stronger. You may see slight improvements in movement, like walking, climbing stairs, or getting up off the floor. It is important to track your progress and review it with your health care provider. Contact your health care provider if you don’t see improvements. </span></p></section></div><div class="article-page " data-page="4"><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-4-10">Are There Reasons This Medicine Should Not Be Used?</h2><p dir="ltr"><span>Elevidys should not be used if you have specific types of genetic mutations, including any deletion of exon 8 or exon 9 in the DMD gene. Your health care provider may test for these specific genetic mutations before giving you Elevidys. </span></p><p dir="ltr"><span>People with a high amount of a specific antibody (Elevidys vector AAVrh74) may not be able to use Elevidys. These antibodies can block the way Elevidys gets to the muscle cells and can cause serious side effects. (See the Side Effects section below.) Your health care provider may do a blood test to check the number of antibodies before starting the infusion. If the number of antibodies is too high, Elevidys should not be used. </span></p><p dir="ltr"><span>The corticosteroid taken before and after Elevidys infusions can cause serious side effects if you have an active infection, like the common cold, flu, stomach flu, ear infection, or respiratory infection. The corticosteroid medicine and Elevidys infusion should not be started if you have an active infection. Tell your health care provider if you have any of the following symptoms of infection: </span></p><ul><li dir="ltr" aria-level="1"><span>Fever or chills</span></li><li dir="ltr" aria-level="1"><span>Body aches</span></li><li dir="ltr" aria-level="1"><span>Coughing or trouble breathing</span></li><li dir="ltr" aria-level="1"><span>Tiredness</span></li><li dir="ltr" aria-level="1"><span>Sneezing</span></li><li dir="ltr" aria-level="1"><span>Runny nose</span></li><li dir="ltr" aria-level="1"><span>Sore throat </span></li></ul></section><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-4-11">How Can I Prevent and Manage Side Effects?</h2><p dir="ltr"><span>The most common side effects of Elevidys are </span><a href="https://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomiting"><span>nausea and vomiting</span></a><span>, which are usually experienced in the first few weeks. Tell your health care provider if you have nausea or vomiting. They may give you medicine for nausea and suggest changes to your diet to ease the symptoms. Make sure that you stay hydrated by drinking plenty of water.</span></p><p dir="ltr"><span>Other common side effects include fever and low platelet levels (</span><a href="https://www.webmd.com/a-to-z-guides/thrombocytopenia-causes-treatment"><span>thrombocytopenia</span></a><span>). Contact your health care provider if you have a fever, as that could be a sign of infection. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your health care provider if you have any of the following symptoms of low platelet levels:</span></p><ul><li dir="ltr" aria-level="1"><span>Easy bruising or bleeding</span></li><li dir="ltr" aria-level="1"><span>Bleeding that does not stop</span></li><li dir="ltr" aria-level="1"><span>Nosebleeds</span></li></ul><p dir="ltr"><span>These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. In the U.S., you can report side effects to the FDA at </span><a href="https://www.fda.gov/medwatch"><span>www.fda.gov/medwatch</span></a><span> or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at </span><a href="https://www.health.gc.ca/medeffect"><span>www.health.gc.ca/medeffect</span></a><span> or by calling 866-234-2345.</span></p></section></div><div class="article-page " data-page="5"><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-5-12">What Monitoring or Blood Tests Might I Need?</h2><p dir="ltr"><span>Your health care provider may perform lab tests to monitor your health before the infusion and assess how your body responds to the medicine. The following are key pieces to that monitoring.</span></p><p dir="ltr"><span><strong>Gene tests. </strong>Your health care provider may do a blood test to see if you have the dystrophin gene before starting Elevidys. They will also see if you have specific mutations to see if Elevidys should not be used.</span></p><p dir="ltr"><span><strong>Antibodies to Elevidys vector</strong>. Your health care provider may do a blood test to check the number of antibodies to the Elevidys vector (AAVrh74) in the blood. This helps prescribe the right dose and see if there may be safety concerns. (See the Adverse Effects section below.) </span></p><p dir="ltr"><span><strong>Infections.</strong> Elevidys should not be started if you have an active infection. </span><a href="https://www.webmd.com/a-to-z-guides/complete-blood-count"><span>Complete blood count (CBC)</span></a><span> is a blood test that can check for infections or other blood disorders. </span></p><p dir="ltr"><span><strong>Liver health.</strong> If you have active liver disease or if your skin or the whites of your eyes appear yellowish (a sign of liver problems), your health care provider may wait to start Elevidys until the liver problems are resolved. A </span><a href="https://www.webmd.com/hepatitis/liver-function-test-lft"><span>liver function test (LFT)</span></a><span> looks for liver damage. After the infusion, your health care provider will check these tests again to look for liver side effects.</span></p></section><section><pagebreak /> <p dir="ltr"><span><strong>Heart muscle health.</strong> DMD can cause inflammation that can damage heart muscle cells. When the heart muscle cells are damaged, they release a protein called troponin into your bloodstream. Your health care provider may monitor the health of your heart muscle by checking troponin levels before giving Elevidys and after the infusion. Contact your health care provider if you have chest pain or shortness of breath, as these may be symptoms of inflammation in your heart.</span></p><p dir="ltr"><span><strong>Platelet levels. </strong>Elevidys may cause a decrease in your platelet levels. Your health care provider may check platelets before giving Elevidys and after the infusion.</span></p></section><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-5-14">What Types of Interactions Can Happen?</h2><p dir="ltr"><span>Before starting the corticosteroid medicine before the Elevidys infusion, your health care provider will review your vaccine history. Corticosteroids weaken the immune system, which can potentially affect the response to a vaccine. Any vaccine needed should be given at least 4 weeks before starting the corticosteroid medicine.</span></p><p dir="ltr"><span>This is not a complete list of medicines that may interact with Elevidys. Tell your pharmacist or health care provider about all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them determine if there are any interactions or if you need a dosage adjustment.</span></p></section></div><div class="article-page " data-page="6"><section><h2 class="jumplink-headers" id="0a6b611b-e358-4624-b08f-47dd31d381de-6-15">Getting Your Medicine: What to Expect</h2><p dir="ltr"><span>Elevidys is given by a health care provider at a hospital or clinic. It requires a different process than picking up a prescription at your local pharmacy. The manufacturer has a program to help support the process for you and your health care provider. You can find out more at </span><a href="https://www.elevidys.com/" rel="nofollow"><span>www.elevidys.com</span></a><span> or by calling 888-727-3782. </span></p><p dir="ltr"><span>Here are some differences that you may expect: </span></p><p dir="ltr"><span><strong>Insurance approval. </strong>Your insurance may require approval for using this medicine, also called a prior authorization. The insurance company reviews the prescription from your health care provider to make sure it is covered and determines the process that needs to be followed. </span></p><p dir="ltr"><span><strong>Using an Elevidys treatment center. </strong>Elevidys infusions are given at select hospitals and clinics in the United States. This ensures that the treatment center has health care providers with experience using gene therapies like Elevidys. </span></p><p dir="ltr"><span><strong>Financial assistance. </strong>There is a financial assistance program from the manufacturer. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. </span></p></section></div></div><div class="related-articles" data-metrics-module="cwnav-art" data-metrics-sel="li"></div><footer><div class="pub-info-and-share-bar"><div class="article__publication-sources"><section class="asset-footer"><div class="asset-footer-top"><div class="asset-footer-buttons"><button class="sources-btn">Sources</button><button class="update-history-btn">Update History</button></div><div class="asset-footer-top-share"><div class="module module-social-share-footer" data-e2e="social-sharebar"><div class="socialshare-container" data-metrics-module="fm-shr"><div class="share-footer-container"><div class="share-text">Share</div><div class="icon-sb-footer-svg icon-sb-footer-share"><svg class="icon-sb-footer-svg" width="18" height="20" viewbox="0 0 18 20" fill="none" xmlns="https://www.w3.org/2000/svg"><path class="icon-sb-footer-svg" d="M15 20C14.1667 20 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17.712C14.4793 17.904 14.7167 18 15 18Z"></path></svg></div></div></div></div><div data-v-00aa1eb2><div class="print-footer-container" data-v-00aa1eb2><div class="print-text" data-v-00aa1eb2>Print</div><div class="icon-sb-footer-print" data-v-00aa1eb2><svg width="20" height="18" viewbox="0 0 20 18" fill="none" xmlns="https://www.w3.org/2000/svg" data-v-00aa1eb2><path d="M14 5V2H6V5H4V0H16V5H14ZM16 9.5C16.2833 9.5 16.5208 9.40417 16.7125 9.2125C16.9042 9.02083 17 8.78333 17 8.5C17 8.21667 16.9042 7.97917 16.7125 7.7875C16.5208 7.59583 16.2833 7.5 16 7.5C15.7167 7.5 15.4792 7.59583 15.2875 7.7875C15.0958 7.97917 15 8.21667 15 8.5C15 8.78333 15.0958 9.02083 15.2875 9.2125C15.4792 9.40417 15.7167 9.5 16 9.5ZM14 16V12H6V16H14ZM16 18H4V14H0V8C0 7.15 0.291667 6.4375 0.875 5.8625C1.45833 5.2875 2.16667 5 3 5H17C17.85 5 18.5625 5.2875 19.1375 5.8625C19.7125 6.4375 20 7.15 20 8V14H16V18ZM18 12V8C18 7.71667 17.9042 7.47917 17.7125 7.2875C17.5208 7.09583 17.2833 7 17 7H3C2.71667 7 2.47917 7.09583 2.2875 7.2875C2.09583 7.47917 2 7.71667 2 8V12H4V10H16V12H18Z" fill="#3557FF" data-v-00aa1eb2></path></svg></div></div></div><div class="save-container"><div class="auth-overlay-popup-holder" data-v-28242611><div class="bookmark-holder drug-generic-name" data-metrics-module="bkmk" data-v-28242611></div></div></div></div></div><div class="asset-footer-content"><div class="sources-section" style="display:none;"><div class="sources-wrapper" data-metrics-module="src"><p dir="ltr"><span>SOURCES:</span></p><p dir="ltr"><i><span>Annals of Neurology: </span></i><span>"Delandistrogene moxeparvovec gene therapy in ambulatory patients (aged ≥4 to <8 years) with Duchenne muscular dystrophy: 1-year interim results from study SRP-9001-103 (ENDEAVOR)." </span></p><p dir="ltr"><span>Elevidys (Sarepta Therapeutics) US Prescribing Information, June 2024.</span></p><p dir="ltr"><i><span>Frontiers in Cell and Developmental Biology: </span></i><span>"Expression of SRP-9001 dystrophin and stabilization of motor function up to 2 years post-treatment with delandistrogene tiparvovec gene therapy in individuals with Duchenne muscular dystrophy."</span></p><p dir="ltr"><i><span>Journal of Neuromuscular Diseases: </span></i><span>"Management of select adverse events following delandistrogene tiparvovec gene therapy for patients with Duchenne muscular dystrophy."</span></p><p dir="ltr"><i><span>Pediatric Neurology: </span></i><span>"Practical considerations for delandistrogene tiparvovec gene therapy in patients with Duchenne muscular dystrophy." </span></p><p dir="ltr"><span>Sarepta Therapeutics: "Sarepta Therapeutics Announces Expanded US FDA Approval of Elevidys to Duchenne Muscular Dystrophy Patients Ages 4 and Above," "Patient Treatment Guide," "Caregiver Treatment Guide," "HCP Treatment Guide."</span></p></div></div></div><div class="asset-footer-bottom"><a href="https://www.webmd.com/about-webmd-policies/about-privacy-policy" class="asset-footer-policy"> View privacy policy, copyright 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All rights reserved."}},"wbmd_prim_med_revr":{"aspen_id":"efc5ef77-8ba4-4951-82af-2e420e23f6ed","wbmd_first_nm":"Goldina","wbmd_middle_name":"I.","wbmd_lst_nm":"Erowele","wbmd_person_prof_ttl":"","wbmd_bio_obj_id":{"directive":"friendlyurl","object_type":"wbmd_cons_article","chronic_id":"4f4bed85-d105-4094-a3d0-a4b47332ba67","legacy_id":"","link_friendlyurl":"https:\u002F\u002Fwww.webmd.com\u002Fbio\u002Fgoldina-erowele","content_section":{"cons_bio":{"title":"Goldina I. Erowele, PharmD, MBA","bio_text":{"#cdata-section":"\u003Cp\u003E\u003Cspan\u003EGoldina I. Erowele, PharmD, MBA, is a seasoned clinical pharmacy and health system leader with extensive expertise across the academic, health system, and public sectors. Erowele's expertise spans drug information, pharmacy education, formulary management, health system pharmacy operations, and medication safety. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan\u003EAs a published author in esteemed journals such as the \u003C\u002Fspan\u003E\u003Ci\u003E\u003Cspan\u003EAmerican Journal of Health-System Pharmacy\u003C\u002Fspan\u003E\u003C\u002Fi\u003E\u003Cspan\u003E and a manuscript\u002Fabstract reviewer for the\u003C\u002Fspan\u003E\u003Ci\u003E\u003Cspan\u003E American Journal of Pharmacotherapy and Pharmaceutical Sciences\u003C\u002Fspan\u003E\u003C\u002Fi\u003E\u003Cspan\u003E, she brings a wealth of experience in medical writing, medical review, and medication use evaluation. Erowele has co-authored a textbook chapter, led multi-health system clinical pharmacy services, and directed pharmacy continuing education programs and accredited pharmacy residency programs. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan\u003EErowele earned her PharmD from Howard University and completed her PGY1 Pharmacy Practice Residency at the Veterans Affairs Medical Center in Washington, DC. She earned her MBA from Texas Woman's University. She completed the Regulatory Affairs Training Program at Duke University’s Office of Regulatory Affairs and Quality. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan\u003EErowele has held several leadership roles and as an adjunct professor. She is a member of the American Medical Writers Association, American Society of Health-System Pharmacists, Academy of Managed Care Pharmacy, and the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas Inc. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E"},"person_photo":{"directive":"imageurl","_chronic_id":"09aafbdf-2985-4638-bad3-45a0a5d4dcac","path":"\u002Fwebmd\u002Fconsumer_assets\u002Fsite_images\u002Farticles\u002Fbiographies\u002FGoldina_Erowele_382x382.jpg","object_type":"wbmd_cons_img"},"related_links_header":"","related_links_text":{"#cdata-section":""}}}},"wbmd_person_suffix_group":{"wbmd_person_suffix":[{"object_type":"wbmd_lookup","wbmd_lookup_type":"person_suffix","wbmd_storage_val":"47","wbmd_disp_nm":"MBA"},{"object_type":"wbmd_lookup","wbmd_lookup_type":"person_suffix","wbmd_storage_val":"60","wbmd_disp_nm":"PharmD"}]},"name":"Goldina I. Erowele, MBA, PharmD","photo":"https:\u002F\u002Fimg.lb.wbmdstatic.com\u002Fvim\u002Flive\u002Fwebmd\u002Fconsumer_assets\u002Fsite_images\u002Farticles\u002Fbiographies\u002FGoldina_Erowele_382x382.jpg","bioUrl":"https:\u002F\u002Fwww.webmd.com\u002Fbio\u002Fgoldina-erowele","intro":"","header":""},"wbmd_prim_revw_dt":"08\u002F06\u002F2024 00:00:00","wbmd_orig_pub_dt":"08\u002F15\u002F2024 09:57:35","wbmd_first_live_dt":"08\u002F15\u002F2024 09:59:26","wbmd_c_prim_top_id":{"wbmd_disp_nm":"Childhood Genetic Diseases (Sensitive Topic)"},"wbmd_c_sec_med_revw_dt":"","wbmd_suppress_infinite":"0"}},"module_data":{"content_section":{"cons_health_ref":{"title":"Your Guide to Elevidys for Duchenne Muscular Dystrophy","section_groups":{"#cdata-section":"\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"1\" \u002F\u003E\u003Cpagebreak type=\"desktop\" order=\"1\" \u002F\u003E\u003Csection_header\u003E\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.webmd.com\u002Fchildren\u002Fduchenne-muscular-dystrophy\"\u003E\u003Cspan\u003EDuchenne muscular dystrophy\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E (DMD) is a genetic disease that causes progressive muscle weakness. DMD commonly affects boys, where symptoms are seen in early childhood. There is no cure for DMD. Health care providers manage symptoms with steroids, physical therapy, and assistive devices (like braces, wheelchairs). New medicines are being studied to help slow the progression of DMD by targeting the abnormal gene. \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.webmd.com\u002Fdrugs\u002F2\u002Fdrug-186998\u002Felevidys-intravenous\u002Fdetails\"\u003E\u003Cspan\u003EElevidys\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E is a new gene therapy medicine for DMD that helps keep muscles strong. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Csection_header\u003EHow Does Elevidys Work?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EMuscles in the body need a protein called dystrophin to work correctly and stay strong. DMD is caused by a genetic mutation that causes the body to make this protein wrong. A mutation is a mistake in the instructions the body uses to make things. Without enough dystrophin, muscles weaken over time. The weakness starts in the legs and pelvis. This makes it hard to run, climb stairs, or get up off the floor. As time goes on, DMD can affect your arms, heart, and lungs. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"2\" \u002F\u003E\u003Csection_header is_continued=\"true\"\u003EHow Does Elevidys Work? continued...\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EDMD is a progressive disease that is usually diagnosed in young children. This means that the symptoms are more noticeable as the child gets older. Since there is no cure for DMD, health care providers manage the symptoms with medicines and physical therapy to help keep muscles strong. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003ENew medicines have been approved to target specific areas of these genetic mistakes or to provide a similar dystrophin protein directly to the muscle cells. This allows the body to start making a similar dystrophin protein. With more dystrophin, the muscles can stay strong longer. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys is one of these medicines, also called gene therapy. Elevidys uses a special virus, called a vector, to get a version of the dystrophin protein to the muscle cells. It helps the body produce a shortened version of the dystrophin protein, potentially slowing the progression of the disease.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Csection_header\u003EHow Should I Use This Medicine?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys is a single, one-time treatment. It is given as an infusion by a health care provider, which means it is delivered directly into the bloodstream through a vein. The infusion is given at a hospital so that you can be monitored closely. The infusion process can take a few hours. Before the infusion, your health care provider may do blood tests to make sure you are ready for the infusion. (See the Monitoring section below.) \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EYour health care provider will start a medicine known as a corticosteroid to help prevent infusion-related side effects. Your vaccines should be up-to-date before starting Elevydis. (See the Interaction section below.) Your health care provider will tell you how to take the medicine and when to stop taking it. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"3\" \u002F\u003E\u003Cpagebreak type=\"desktop\" order=\"2\" \u002F\u003E\u003Csection_header\u003EHow Was It Studied for DMD? \u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThree studies have been done to look at the safety and efficacy of Elevidys for the treatment of DMD. Two studies (study 1 and study 3) were placebo-controlled, which helps researchers see differences in benefit or harm of a medicine when compared with no treatment. People in the study had a diagnosis of DMD with specific gene mutations. The following information was similar for all the studies.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003EPatients were male (100%) and were 4 to 8 years of age, with an average age of 6 years and average weight of 50 pounds.\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003EMost people receiving Elevidys in the studies were White (76%), with 12% who identified as Asian, 7% as other, 2% as African American or Black, 2% as \"not reported,\" and 1% as multiple races. All people in the study took a corticosteroid medicine before getting the infusion and had antibody levels below the level determined to be safer for Elevidys infusion.\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EStudy 1 had two phases, where people received one infusion of either Elevidys or placebo. The placebo infusion did not have active medicine. The people were monitored for improvements and side effects for 48 weeks. After the first 48 weeks, people in the study switched to receiving either Elevidys or placebo, the opposite of what they received in the first phase. (See the table below.) All of the people in the study were ambulatory, meaning they were able to walk without assistance. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cdiv dir=\"ltr\" align=\"left\"\u003E\u003Ctable\u003E\u003Ctbody\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EStudy Group\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EPhase 1: 48 Weeks\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EPhase 2: 48 Weeks\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EGroup 1\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EPlacebo\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EGroup 2\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EPlacebo \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003Ctd\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003C\u002Ftbody\u003E\u003C\u002Ftable\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"4\" \u002F\u003E\u003Cpagebreak \u002F\u003E\u003Csection_header is_continued=\"true\"\u003EHow Was It Studied for DMD? continued...\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EIn study 2, all people in the study received Elevidys. There was no placebo. A small number of people (17%) were non-ambulatory, meaning they were no longer able to walk independently. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EIn study 3, people in the study received either an Elevidys or placebo infusion. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThe effectiveness of Elevidys in the studies was based on changes in the North Star Ambulatory Assessment (NSAA) score and\u002For changes in the amount of micro-dystrophin proteins in the skeletal muscles. NSAA is a test that measures how well someone with DMD can move and do their everyday activities. The maximum score is 34. A lower score shows that a person has limited mobility or poor muscle health. The average NSAA score in all studies was 21-23, which means that the person had some limitations in their movement, but they were still able to do most daily activities. Other results looked at the ability to move by timing events like walking\u002Frunning a distance, climbing four stairs, and standing from lying down. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"5\" \u002F\u003E\u003Cpagebreak type=\"desktop\" order=\"3\" \u002F\u003E\u003Csection_header\u003EWhat Benefits Were Seen in the Studies?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EPeople who received Elevidys in the studies saw improvements in NSAA scores, increases in the amount of dystrophin in their muscles, and positive changes in their timed movements. This means that their muscles were a little stronger and they had more ability to move compared to the people who received a placebo. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EChange in NSAA scores. At the end of the studies, people who received Elevidys had an average improvement in their NSAA scores by 2 points compared with a small decrease in scores for the people who received placebo. This means that Elevidys strengthened their muscles, allowing easier movement in their daily activities. The change in scores were greater in younger children who received Elevidys (ages 4-7).\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EChange in dystrophin proteins. Elevidys delivers a version of the dystrophin protein, which causes the body to start making natural dystrophin. In two studies, the amount of dystrophin in the muscle cells increased. The levels were like what is expected for normal muscles. This could mean that having more dystrophin in the muscle cells could protect the muscles from further damage. Further studies are needed to see how long this effect would last. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"6\" \u002F\u003E\u003Cpagebreak \u002F\u003E\u003Csection_header is_continued=\"true\"\u003EWhat Benefits Were Seen in the Studies? continued...\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EAbility to move. In the studies, the mobility of each person was timed when they were doing the following three activities.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ETime to rise, which is the time it takes the person to move from lying down to standing\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ETime to walk\u002Frun 10 meters and 100 meters\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ETime to climb four stairs\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThe studies showed that people who received Elevidys had improvements in the timing of these activities compared with the people who received placebo. Patients receiving Elevidys were able to complete these movements slightly faster. Further studies are needed to see how long this effect would last. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EYour results may differ from what was seen in clinical studies. You and your health care provider should determine if the benefits outweigh any potential risks. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Csection_header\u003EWhen Will the Medicine Start Working?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EIt may take up to a few years to see the benefits from Elevidys. As the body starts to make its own dystrophin for muscles, the muscles may slowly start to become stronger. You may see slight improvements in movement, like walking, climbing stairs, or getting up off the floor. It is important to track your progress and review it with your health care provider. Contact your health care provider if you don’t see improvements. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"7\" \u002F\u003E\u003Cpagebreak type=\"desktop\" order=\"4\" \u002F\u003E\u003Csection_header\u003EAre There Reasons This Medicine Should Not Be Used?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys should not be used if you have specific types of genetic mutations, including any deletion of exon 8 or exon 9 in the DMD gene. Your health care provider may test for these specific genetic mutations before giving you Elevidys. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EPeople with a high amount of a specific antibody (Elevidys vector AAVrh74) may not be able to use Elevidys. These antibodies can block the way Elevidys gets to the muscle cells and can cause serious side effects. (See the Side Effects section below.) Your health care provider may do a blood test to check the number of antibodies before starting the infusion. If the number of antibodies is too high, Elevidys should not be used. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThe corticosteroid taken before and after Elevidys infusions can cause serious side effects if you have an active infection, like the common cold, flu, stomach flu, ear infection, or respiratory infection. The corticosteroid medicine and Elevidys infusion should not be started if you have an active infection. Tell your health care provider if you have any of the following symptoms of infection: \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003EFever or chills\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003EBody aches\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ECoughing or trouble breathing\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ETiredness\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ESneezing\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ERunny nose\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ESore throat \u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"8\" \u002F\u003E\u003Csection_header\u003EHow Can I Prevent and Manage Side Effects?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThe most common side effects of Elevidys are \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.webmd.com\u002Fdigestive-disorders\u002Fdigestive-diseases-nausea-vomiting\"\u003E\u003Cspan\u003Enausea and vomiting\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E, which are usually experienced in the first few weeks. Tell your health care provider if you have nausea or vomiting. They may give you medicine for nausea and suggest changes to your diet to ease the symptoms. Make sure that you stay hydrated by drinking plenty of water.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EOther common side effects include fever and low platelet levels (\u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.webmd.com\u002Fa-to-z-guides\u002Fthrombocytopenia-causes-treatment\"\u003E\u003Cspan\u003Ethrombocytopenia\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E). Contact your health care provider if you have a fever, as that could be a sign of infection. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your health care provider if you have any of the following symptoms of low platelet levels:\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003EEasy bruising or bleeding\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003EBleeding that does not stop\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli dir=\"ltr\" aria-level=\"1\"\u003E\u003Cspan\u003ENosebleeds\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThese are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. In the U.S., you can report side effects to the FDA at \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.fda.gov\u002Fmedwatch\"\u003E\u003Cspan\u003Ewww.fda.gov\u002Fmedwatch\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.health.gc.ca\u002Fmedeffect\"\u003E\u003Cspan\u003Ewww.health.gc.ca\u002Fmedeffect\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E or by calling 866-234-2345.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"9\" \u002F\u003E\u003Cpagebreak type=\"desktop\" order=\"5\" \u002F\u003E\u003Csection_header\u003EWhat Monitoring or Blood Tests Might I Need?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EYour health care provider may perform lab tests to monitor your health before the infusion and assess how your body responds to the medicine. The following are key pieces to that monitoring.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EGene tests. \u003C\u002Fstrong\u003EYour health care provider may do a blood test to see if you have the dystrophin gene before starting Elevidys. They will also see if you have specific mutations to see if Elevidys should not be used.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EAntibodies to Elevidys vector\u003C\u002Fstrong\u003E. Your health care provider may do a blood test to check the number of antibodies to the Elevidys vector (AAVrh74) in the blood. This helps prescribe the right dose and see if there may be safety concerns. (See the Adverse Effects section below.) \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EInfections.\u003C\u002Fstrong\u003E Elevidys should not be started if you have an active infection. \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.webmd.com\u002Fa-to-z-guides\u002Fcomplete-blood-count\"\u003E\u003Cspan\u003EComplete blood count (CBC)\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E is a blood test that can check for infections or other blood disorders. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003ELiver health.\u003C\u002Fstrong\u003E If you have active liver disease or if your skin or the whites of your eyes appear yellowish (a sign of liver problems), your health care provider may wait to start Elevidys until the liver problems are resolved. A \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.webmd.com\u002Fhepatitis\u002Fliver-function-test-lft\"\u003E\u003Cspan\u003Eliver function test (LFT)\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E looks for liver damage. After the infusion, your health care provider will check these tests again to look for liver side effects.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"10\" \u002F\u003E\u003Cpagebreak \u002F\u003E\u003Csection_header is_continued=\"true\"\u003EWhat Monitoring or Blood Tests Might I Need? continued...\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EHeart muscle health.\u003C\u002Fstrong\u003E DMD can cause inflammation that can damage heart muscle cells. When the heart muscle cells are damaged, they release a protein called troponin into your bloodstream. Your health care provider may monitor the health of your heart muscle by checking troponin levels before giving Elevidys and after the infusion. Contact your health care provider if you have chest pain or shortness of breath, as these may be symptoms of inflammation in your heart.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EPlatelet levels. \u003C\u002Fstrong\u003EElevidys may cause a decrease in your platelet levels. Your health care provider may check platelets before giving Elevidys and after the infusion.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Csection_header\u003EWhat Types of Interactions Can Happen?\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EBefore starting the corticosteroid medicine before the Elevidys infusion, your health care provider will review your vaccine history. Corticosteroids weaken the immune system, which can potentially affect the response to a vaccine. Any vaccine needed should be given at least 4 weeks before starting the corticosteroid medicine.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EThis is not a complete list of medicines that may interact with Elevidys. Tell your pharmacist or health care provider about all the prescription or over-the-counter (OTC) medicines, vitamins\u002Fminerals, herbal products, or other supplements you take or have recently taken. This will help them determine if there are any interactions or if you need a dosage adjustment.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E\u003Csection_group\u003E\u003Cpagebreak type=\"mobile\" order=\"11\" \u002F\u003E\u003Cpagebreak type=\"desktop\" order=\"6\" \u002F\u003E\u003Csection_header\u003EGetting Your Medicine: What to Expect\u003C\u002Fsection_header\u003E\u003Csection_text\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys is given by a health care provider at a hospital or clinic. It requires a different process than picking up a prescription at your local pharmacy. The manufacturer has a program to help support the process for you and your health care provider. You can find out more at \u003C\u002Fspan\u003E\u003Ca link_friendlyurl=\"https:\u002F\u002Fwww.elevidys.com\u002F\" rel=\"nofollow\"\u003E\u003Cspan\u003Ewww.elevidys.com\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003Cspan\u003E or by calling 888-727-3782. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EHere are some differences that you may expect: \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EInsurance approval. \u003C\u002Fstrong\u003EYour insurance may require approval for using this medicine, also called a prior authorization. The insurance company reviews the prescription from your health care provider to make sure it is covered and determines the process that needs to be followed. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EUsing an Elevidys treatment center. \u003C\u002Fstrong\u003EElevidys infusions are given at select hospitals and clinics in the United States. This ensures that the treatment center has health care providers with experience using gene therapies like Elevidys. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003E\u003Cstrong\u003EFinancial assistance. \u003C\u002Fstrong\u003EThere is a financial assistance program from the manufacturer. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003C\u002Fsection_text\u003E\u003Chighlights\u003E\u003C\u002Fhighlights\u003E\u003Cpull_quotes\u003E\u003C\u002Fpull_quotes\u003E\u003C\u002Fsection_group\u003E"},"citations":{"#cdata-section":"\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003ESOURCES:\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Ci\u003E\u003Cspan\u003EAnnals of Neurology: \u003C\u002Fspan\u003E\u003C\u002Fi\u003E\u003Cspan\u003E\"Delandistrogene moxeparvovec gene therapy in ambulatory patients (aged ≥4 to <8 years) with Duchenne muscular dystrophy: 1-year interim results from study SRP-9001-103 (ENDEAVOR).\" \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003EElevidys (Sarepta Therapeutics) US Prescribing Information, June 2024.\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Ci\u003E\u003Cspan\u003EFrontiers in Cell and Developmental Biology: \u003C\u002Fspan\u003E\u003C\u002Fi\u003E\u003Cspan\u003E\"Expression of SRP-9001 dystrophin and stabilization of motor function up to 2 years post-treatment with delandistrogene tiparvovec gene therapy in individuals with Duchenne muscular dystrophy.\"\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Ci\u003E\u003Cspan\u003EJournal of Neuromuscular Diseases: \u003C\u002Fspan\u003E\u003C\u002Fi\u003E\u003Cspan\u003E\"Management of select adverse events following delandistrogene tiparvovec gene therapy for patients with Duchenne muscular dystrophy.\"\u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Ci\u003E\u003Cspan\u003EPediatric Neurology: \u003C\u002Fspan\u003E\u003C\u002Fi\u003E\u003Cspan\u003E\"Practical considerations for delandistrogene tiparvovec gene therapy in patients with Duchenne muscular dystrophy.\" \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\u003Cp dir=\"ltr\"\u003E\u003Cspan\u003ESarepta Therapeutics: \"Sarepta Therapeutics Announces Expanded US FDA Approval of Elevidys to Duchenne Muscular Dystrophy Patients Ages 4 and Above,\" \"Patient Treatment Guide,\" \"Caregiver Treatment Guide,\" \"HCP Treatment Guide.\"\u003C\u002Fspan\u003E\u003C\u002Fp\u003E"},"related_links_header":"","related_links_text":{"#cdata-section":""}}}}}},"staticPublicPath":"\u002Fstatic_vue\u002F091e9c5e81e4870f\u002Fclient\u002F","isInteractivePage":false},"flow":{"flowInfo":false},"quiz":{"rmq":{}}}</script> <script>window.__INITIAL_STATE__.route.hash = window.location.hash; window.__INITIAL_STATE__.route.fullPath = window.location.pathname; window.__INITIAL_STATE__.route.path = window.location.pathname; if(window.location.search !== ""){ var search = window.location.search.substring(1); window.__INITIAL_STATE__.route.query=JSON.parse('{"' + search.replace(/&/g, '","').replace(/=/g,'":"') + '"}', function(key, value) { return key===""?value:decodeURIComponent(value) }) } else {window.__INITIAL_STATE__.route.query={};}</script><script>try{var _comscore=_comscore||[];_comscore.push({c1:'2',c2:'6035829',options:{enableFirstPartyCookie:!0}}),function(){var e=document.createElement('script'),o=document.getElementsByTagName('script')[0];e.async=!0,e.src='https://sb.scorecardresearch.com/cs/6035829/beacon.js',o.parentNode.insertBefore(e,o),window.__INITIAL_STATE__?window.document.addEventListener('before_pv',function(){window.document.addEventListener('onAdobeOmniBeforePv',function(){window.biConsumerIsReady&&self.COMSCORE&&COMSCORE.beacon({c1:'2',c2:'6035829',options:{enableFirstPartyCookie:!0}})})},{once:!0}):window.document.addEventListener('onAdobeOmniBeforePv',function(){self.COMSCORE&&COMSCORE.beacon({c1:'2',c2:'6035829',options:{enableFirstPartyCookie:!0}})})}()}catch(e){}</script><noscript><img src='https://sb.scorecardresearch.com/p?c1=2&c2=6035829&cv=3.9.1&cj=1'></noscript>  <script id="cookieConsentScriptNonEU" async="async" src="https://img.lb.wbmdstatic.com/webmd_static_vue/file-explorer/webmd/consumer_assets/site_images/webmd-ccm/webmd-ccm-lite.min.js"></script><script type="text/javascript" async="async" importance="high" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js" id="GPT_JS"></script><script>window.webmd.googleloaded = true; window.googleloaded = true; </script> <script>window.performance.mark('page-end');</script> <link rel="stylesheet" href="//img.lb.wbmdstatic.com/webmd_static_vue/091e9c5e81e4870f/client/css/non-critical-1738228149036.07245cc1.css"> </body> </html>