Earnings roundup: Neurocrine slumps, Alnylam battles skeptics and Ascendis eyes a competitor

With quarterly earnings underway, BioPharma Dive is providing a snapshot of some companies’ results and how they’re being received by investors. Today, we’re offering insight into the latest numbers from Neurocrine Biosciences, Alnylam Pharmaceuticals and Ascendis Pharma.

Neurocrine again disappoints some investors

Shares of Neurocrine Biosciences fell by over 10% on Thursday, wiping more than $1 billion in value from the brain-focused biotechnology company. The drop followed a Wednesday afternoon earnings report in which Neurocrine said net product sales in the fourth quarter and 2025 overall totaled $798 million and $2.83 billion. Those figures are respectively 29% and 22% higher year-over-year. Ingrezza, a drug for movement issues associated with Huntington's disease, accounted for more than 80% of overall sales. The remainder mostly came from Crenessity, a treatment approved in 2024 for a rare, genetic condition that can cause life-threatening shortages of crucial hormones. Brian Abrahams, an analyst at RBC Capital Markets, suspects a combination of factors may be concerning some investors. One is Neurocrine's guidance. The company expects that, over the course of this year, net sales from Ingrezza will be in the range of $2.7 billion to $2.8 billion. That might not be as high as shareholders had hoped. Neurocrine executives also recently disclosed plans to spend another $150 million building out the sales teams for those two leading products — a decision that could be seen as bad for near-term margins. Additionally, Abrahams noted how some are worried about Crenessity’s growth prospects, specifically with regard to the number of new patients starting on the drug. Neurocrine says there are roughly 20,000 people in the U.S. with that rare condition, “congenital adrenal hyperplasia,” and, across last year, about 2,050 began taking Crenessity. Sales figures indicate the final three months of 2025 averaged fewer starts, at 431, than previous quarters. Even so, Abrahams and his team see the fears as overblown. “Though we acknowledge investor consternation around margins and Crenessity launch dynamics could persist ... we believe today’s downside reaction will prove to be a compelling buying opportunity,” he wrote in a note to clients. “Ingrezza looks poised for a major beat,” he added, and Crenessity “should be fine [as] we have always anticipated some continued slowdown” in new patient starts. “Overall, we see much growth left in both key franchises,” wrote TD Cowen analyst Phil Nadeau in his own client note.

Alnylam bitten by its success

A similar situation played out with Alnylam Pharmaceuticals. The company, which specializes in so-called RNA interference drugs, gave a preliminary look at fourth-quarter and full-year earnings last month, then released its official report Thursday. It recorded nearly $3 billion across all of 2025 and almost $1 billion over those final three months, reflecting increases of 81% and 121% compared to the same periods the prior year. Despite that performance, Alnylam shares had slipped around 4% by the time trading closed Thursday afternoon. Though the company sells half a dozen drugs, nearly 80% of its product revenue comes from Amvuttra, a treatment for the nerve damage and heart failure associated with a rare disorder known as ATTR. Alnylam has said this disorder, which has a couple subtypes, affects north of a few hundred thousand people worldwide. For 2026, the company expects net product revenue to reach $4.9 billion to $5.3 billion, with Amvuttra and another ATTR medicine, Onpattro, responsible for up to $4.7 billion of that sum. To Paul Matteis, an analyst at Stifel, the main debate among investors is whether Amvuttra can meet or beat this guidance, and whether Alnylam can keep pace finding new patients to get on the drug. Alnylam is “somewhat a victim of its own success after two very strong quarters” for Amvuttra, Matteis wrote. Yet, while some investors may have wanted even more from the latest earnings, “the underlying fundamentals here still seem strong.” To that end, Alnylam said Amvuttra’s approval last spring for those cardiovascular problems tied to ATTR was a primary reason why patient demand for the drug grew roughly 250% in the fourth quarter. The company estimates that, globally, around 80% of patients with this condition, which stiffens the heart and impairs its function, remain undiagnosed. The number of identified patients has, on average, grown 40% annually since 2019, according to Alnylam. “There are simply many tailwinds for the mid-to-long term, even if short-term expectations had gotten ahead of themselves,” Matteis wrote.

Ascendis numbers overshadowed by competitor

Denmark-based Ascendis Pharma also provided an early glance at earnings in January. Its full report, out Wednesday , detailed fourth-quarter product revenue of 240 million euros, or about $279 million. Full-year product revenue hit 684 million euros, with 70% coming from Yorvipath, a drug for a rare illness where the body doesn’t produce enough of a hormone that regulates vital minerals. The results were in-line with analyst forecasts. Joseph Schwartz, of Leerink Partners, expects Yorvipath’s momentum to continue throughout this year, and described Ascendis’ goal of the drug surpassing $1 billion in revenue as “achievable.” The company’s share price, however, slumped 5% at market’s open Thursday. Though the stock would rebound over the following hours, Ascendis’ earnings appeared to take a back seat to data from a rival. Early that morning, BridgeBio Pharma disclosed positive findings from a late-stage study evaluating one of its most advanced drugs — an oral enzyme-blocker named infigratinib — as a growth-inducing treatment for “achondroplasia,” the most common type of dwarfism. Ascendis has been testing a once-weekly injectable therapy in this setting, and could receive approval from the Food and Drug Administration before the end of February. With “few surprises” in Ascendis’ results, the update from BridgeBio served as “bigger news” and reinforced that this oral option creates competition, wrote Li Watsek of Cantor Fitzgerald. Yaron Werber, a TD Cowen analyst who covers Ascendis, acknowledged that BridgeBio’s drug appears “solid,” with “clean safety.” And, if approved, it will likely dominate the achondroplasia market as both an initial and second-line treatment. In Werber’s view, the key to Ascendis being able to compete is securing strong data from a Phase 3 study of its “TransCon CNP” therapy combined with its already approved product for growth hormone deficiency. In earlier testing, Ascendis said this pairing, when used in certain people with achondroplasia, tripled the effectiveness seen when TransCon CNP was used alone. The combination should eventually become the standard-of-care in achondroplasia, Werber wrote.