IONS Q2 2026: $268M Revenue, Salanersen SMA Breakthrough

Ionis Pharmaceuticals (IONS) reported Q2 2026 revenue of $268 million, down from $452 million in Q2 2025, which included a one-time sapablursen upfront payment. Strip that out and revenue grew 56% year over year. The net loss was $115 million, or $0.69 per share. IONS closed at $54.04 on July 29.

The earnings release carried more pipeline news than the financials. Four items stood out.

Salanersen enters Phase 3 with FDA Breakthrough Therapy. The FDA granted Breakthrough Therapy Designation to salanersen, an antisense oligonucleotide for spinal muscular atrophy (SMA). Biogen, which licensed the drug from Ionis, is running three global Phase 3 trials: STELLAR-1, STELLAR-2, and SOLAR. All three evaluate an 80 mg dose administered once yearly by intrathecal injection. If approved, salanersen would be the first annual-dose SMA therapy, challenging Novartis’s Zolgensma gene therapy and Biogen’s own SPINRAZA, which is dosed every four months. Ionis earns royalties on SPINRAZA, so a successor cannibalizes existing revenue but at a higher margin if the drug is co-commercialized.

Obudanersen REVEAL enrollment complete. Ionis completed enrollment in the registrational cohort of the Phase 3 REVEAL study of obudanersen (ION582) for Angelman syndrome, a neurological disorder with no approved treatments. The adult cohort is expected to finish enrollment in Q3 2026. Topline data is anticipated in the second half of 2027. Obudanersen targets the UBE3A antisense transcript to restore UBE3A protein production. Ionis faces competition in this indication: Ultragenyx (RARE) has fully enrolled its Phase 3 Aspire study of GTX-102, with data expected in H2 2026, and Oak Hill Bio is advancing rugonersen as a third ASO entrant.

TRYNGOLZA launches in sHTG. The FDA approved TRYNGOLZA (olezarsen) for severe hypertriglyceridemia in late June 2026, and the drug generated $5 million in Q2 product sales, with $32 million year to date. The sHTG launch is showing early momentum. Ionis raised peak sales guidance for olezarsen to over $2 billion. DAWNZERA (donidalorsen) for hereditary angioedema contributed $26 million in Q2, bringing year-to-date product sales to $42 million. Commercial revenue totaled $119 million, up 15% from Q2 2025.

Two more FDA decisions by October. Zilganersen for Alexander disease has a PDUFA date of September 22, 2026, with Priority Review. Bepirovirsen for chronic hepatitis B, partnered with GSK, has a PDUFA date of October 26, 2026. Both are covered in our rare disease PDUFA catalysts roundup. A zilganersen approval would be the first treatment for Alexander disease. A bepirovirsen approval would deliver the first functional cure therapy for chronic hepatitis B, a market of 250 million patients worldwide.

The financial backdrop matters. Ionis held $2.06 billion in cash and short-term investments at June 30, down from $2.68 billion a year earlier. The H1 operating loss was $220 million. The company maintained its 2026 revenue guidance of $875 to $900 million and reiterated its cashflow breakeven target for 2028. That timeline requires commercial revenue to ramp fast, especially with the eplontersen failure in ATTR cardiomyopathy narrowing the cardiovascular pipeline.

The risk is execution. Four commercial launches in 12 months is a stretch for a company that only began selling its own drugs last year. Salanersen is years from approval, and obudanersen data is 14 months away. The next two quarters of TRYNGOLZA and DAWNZERA sales will show whether Ionis can hit its 2028 breakeven or needs another partnership to bridge the gap.

Source: Ionis Q2 2026 press release | StockTitan 8-K summary