AKBA — Akebia Therapeutics, Inc.

Summary of Akebia's Q1 2026 Earnings Call

1. Key Financial Results and Metrics

• Total Revenues: $53.5 million, down from $57.3 million in Q1 2025.
• Vafseo Net Product Revenues: $15.8 million, a 32% increase from $12 million in Q1 2025, marking the highest quarter of Vafseo revenue to date.
• Auryxia Net Product Revenues: $36.2 million, down from $43.8 million in Q1 2025, attributed to lower pricing and increased generic competition.
• Net Loss: $9.1 million, compared to a net income of $6.1 million in Q1 2025.
• Cash and Cash Equivalents: $162.6 million as of March 31, 2026, down from $184.8 million at the end of 2025.

2. Strategic Updates and Business Highlights

• Vafseo Launch: Strong growth in prescribing and patient numbers, with 7,500 patients on Vafseo by the end of Q1 2026, a 60% increase from Q4 2025. The number of prescribers increased by 28% to approximately 1,025.
• Clinical Evidence: Positive data from the Phase III INNOVATE program and ongoing studies (VOCAL and VOICE) are expected to support Vafseo's position as the standard of care for dialysis patients.
• Pipeline Development: Advancements in kidney disease-focused R&D, including ongoing trials for praliciguat (FSGS) and AKB-9090 (acute kidney injury), with expectations for initial data in 2027.

3. Forward Guidance and Outlook

• Vafseo Growth: Anticipated continued growth in 2026, particularly as more dialysis organizations adopt observed dosing protocols. The company expects significant revenue growth, especially from organizations implementing these protocols.
• Auryxia Revenue Decline: Expected to continue decreasing throughout 2026 due to increased generic competition.
• Cash Position: Management believes current cash resources will sustain operations for at least two years.

4. Bad News, Challenges, or Points of Concern

• Declining Auryxia Revenues: The company faces challenges with Auryxia due to pricing pressures and competition from generics, leading to a forecasted decline in revenues.
• Net Loss: Transition from profit to loss raises concerns about financial sustainability, particularly with increased expenses in R&D and SG&A.
• Market Competition: The entry of new treatments for kidney diseases, such as sparsentan for FSGS, poses competitive pressures that could impact enrollment and market share for Akebia's pipeline products.

5. Notable Q&A Insights

• Patient Growth: The increase in patients on Vafseo was broad-based across dialysis organizations, with USRC showing significant growth due to the transition to observed dosing protocols.
• Enrollment Dynamics: The approval of competing products like Filspari is not expected to significantly impact enrollment for praliciguat trials, as many patients will still require additional treatment options.
• Adherence Rates: First refill adherence for patients on observed dosing protocols is at 86%, which is expected to remain stable as more organizations adopt these protocols.
• Future Growth: The growth trajectory for Vafseo is uncertain, with potential for acceleration dependent on DaVita's adoption of observed dosing protocols later in the year.

Overall, Akebia's Q1 2026 results reflect a strong start for Vafseo amidst challenges with Auryxia and increasing competition in the kidney disease market. The company remains focused on expanding its presence and establishing Vafseo as a standard treatment option.