Muscle targeting complexes and formulations for treating myotonic dystrophy

A complex comprising a structure of the formula (Id):

• wherein the oligonucleotide of formula (Id) comprises a sequence of CAGCGCCCACCAGUCA (SEQ ID NO:
• 21), wherein for each nucleoside, N, of the oligonucleotide, +N represents an LNA ribonucleoside, dN represents a 2′-deoxyribonucleoside, oN represents a 2′-O-methoxyethyl (MOE) modified ribonucleoside, oC represents a 5-methyl-2′-MOE-cytidine, +C represents a 5-methyl-2′-4′-bicyclic-cytidine, wherein the 2′ and 4′ positions of the sugar are bridged via a methylene, oU represents a 5-methyl-2′-MOE-uridine, and wherein * represents a phosphorothioate internucleoside linkage;
• wherein R2 comprises a Fab comprising a heavy chain comprising the amino acid sequence of SEQ ID NO:
• 19 and a light chain comprising the amino acid sequence of SEQ ID NO:
• 20;
• wherein n1 is an integer representing the number of instances of the group enclosed by square brackets, wherein each instance of the group enclosed by square brackets is covalently linked to a different amino acid residue of the Fab.