
Thymidine kinase 2 deficiency is an ultra-rare, life-threatening mitochondrial myopathy that, until recently, had no approved treatment options beyond supportive care. The FDA approval of doxecitine and doxribtimine in November 2025 -- followed by EMA approval in March 2026 -- marked a turning point for patients, particularly those with early symptom onset. In this Special Report, Dr. Michio Hirano, a lead author of the pivotal publication in Brain Communications and a central figure in TK2d research, breaks down the integrated efficacy and safety data, what it means for clinical practice, and where the field goes from here.





























