Ionis trims Tryngolza revenue forecast to roughly $50m as sHTG rollout proves slower

Ionis Pharmaceuticals has scaled back what it expects Tryngolza (olezarsen) to earn this year, now pointing to about $50m in 2026 sales. The company blamed a slower build-up than it had planned for in severe hypertriglyceridemia (sHTG), the indication it is counting on to widen the drug's reach.

The reduction came with the company's third-quarter 2026 results, published on 9 November. Revenue for the quarter was $243m. Ionis did not alter its guidance for total revenue, operating loss or cash, so the shortfall in Tryngolza is not presented as changing the wider financial picture.

Ionis also stood by its Dawnzera (donidalorsen) sales forecast of $110m to $120m. Separately, it has begun selling Zanvastro (zilganersen) for Alexander disease. The material available does not cover pricing, geographies or patient numbers for that launch, so its commercial potential cannot yet be gauged.

In Europe, Tryngolza has a positive CHMP opinion in sHTG, and Ionis expects the European Commission to issue its final decision in the fourth quarter of 2026. By way of context, the Commission typically follows a positive CHMP opinion, a step that clears the way for marketing across EU member states.