I commented this in a different thread on this news story, but this approval in an interesting one in that it has been approved using the accelerated approval pathway because there was an unmet clinical need. However, if you look at the clinical landscape, there are other options for treatment (also from Sarepta I should mention). Additionally, the interim clinical data showed protein expression which is what the FDA cited in their approval, however that interim data did not show significant positive clinical benefit. From PBS:
FDA scientists detailed a long list of concerns with the company’s research, particularly a mid-stage study that the company submitted for FDA review. Overall, it failed to show that boys who received the therapy performed significantly better on measures like standing, walking and climbing than those who got a dummy treatment
Accelerated approval pathways make sense in many cases they are used, however, the agency should beware allowing accelerated approval being abused by drugmakers to get a drug to market quickly and then slow-walk the post-approval obligations (which are usually very expensive phase 3 studies). Being too liberal with accelerated approvals incentivizes questionably efficacious therapies that are simply used as a profit tool before the data shows the full extent of their clinical impact.
I recently posted an opinion piece that talks about this in some more detail and provided some additional thoughts in that thread. I am not a specialist when it comes to regulatory practices or strategy, but simply a scientist in the field that is concerned about potential abuse of a regulatory mechanism that has the potential to cause harm to patients.