Alnylam revenue jumps 74% to $1.2B as AMVUTTRA hits $1B quarterly

Alnylam Pharmaceuticals Inc. reported second-quarter net product revenue of about $1.2 billion, up 74% from a year earlier, as its heart-disease drug AMVUTTRA surpassed $1 billion in quarterly sales for the first time.

"The quarter marked the first time AMVUTTRA revenue exceeded $1 billion in a single quarter," Chief Executive Officer Yvonne Greenstreet said on the earnings call. The result represents an annualized revenue run rate of more than $4 billion about 15 months after the drug's launch in transthyretin amyloidosis with cardiomyopathy, or ATTR-CM.

Revenue fell short of the $1.32 billion consensus estimate compiled by Zacks, while adjusted earnings of $1.84 a share missed the $2.15 analyst forecast. Total TTR franchise revenue reached $1.03 billion, up 89% year over year and 13% sequentially. Rare disease portfolio revenue added $142 million, up 11%. The company reported non-GAAP operating income of $318 million, more than triple the prior-year amount, and ended the quarter with $3.3 billion in cash and securities.

Alnylam lowered its 2026 TTR revenue forecast to a range of $4.2 billion to $4.5 billion, a $200 million reduction at the midpoint from its prior outlook, citing normalization of second-line demand after an initial surge from patients switching off stabilizer therapies. The revised range still implies 75% annual TTR revenue growth at the midpoint, Chief Financial Officer Jeff Poulton said. The company raised its collaboration and royalty revenue outlook to $575 million to $625 million, a $150 million increase at the midpoint, driven by higher royalties from Novartis AG's LEQVIO sales and cost reimbursement from Roche Holding AG related to the ZENITH Phase III trial of zilebesiran.

About 80% of new ATTR-CM treatment starts are now first-line, Chief Commercial Officer Tolga Tanguler said, a shift the company views as the larger and more durable growth opportunity. Alnylam estimates roughly 200,000 U.S. ATTR-CM patients exist and that about 80% remain untreated. The company has added more than 1,700 prescribers since launch but has reached only about one-third of the growing pool of TTR prescribers, Tanguler said.

On the competitive front, Greenstreet pointed to a delay in expected U.S. generic entry for tafamidis until mid-2031 and the negative top-line result from the CARDIO-TTRansform study of eplontersen, which she said could leave one fewer branded competitor in ATTR-CM. Chief Research and Development Officer Pushkal Garg said the eplontersen outcome has not changed Alnylam's confidence in TRITON-CM, its Phase III cardiovascular outcomes study of investigational RNAi therapy nucresiran. Based on preliminary Phase I results, nucresiran produced more than 95% TTR knockdown with twice-yearly dosing, according to the company.

Alnylam also announced a collaboration with BeOne for exclusive commercialization and distribution rights for AMVUTTRA in mainland China and Macau, and initiated Phase II trials of ALN-6400 in von Willebrand disease and migalastat in Down syndrome-associated Alzheimer's disease. Four data readouts are expected in the second half of 2026, including initial Phase I results for ALN-HTT02 in Huntington's disease and Phase I data for ALN-2232 in obesity and weight management.

Shares fell 3.8% on the day of the earnings release. The guidance trim signals that the initial demand surge from stabilizer-switching patients has run its course, but the shift toward first-line prescribing and the large untreated patient pool support the long-term growth thesis. Investors will watch for enrollment updates from the TRITON-CM study and data readouts from the early-stage pipeline in the second half of 2026.

This article is for informational purposes only and does not constitute investment advice.