Ionis reports fourth quarter and full year 2023 financial results

WAINUA(TM) approved with launch underway; on track for EU and Canada approval decisions this year

Positive Phase 3 olezarsen and donidalorsen data, preparing regulatory submissions for FCS and HAE, respectively

Olezarsen granted Breakthough Therapy designation by the FDA for FCS

Ionis provides full year 2024 financial guidance

CARLSBAD, Calif., Feb. 21, 2024 /PRNewswire/ -- Ionis Pharmaceuticals, Inc. (Nasdaq: IONS) (the "Company"), today reported financial results for the fourth quarter and full year ended December 31, 2023.

"This past year included many remarkable achievements as we continued to advance our vision to bring better futures to people with serious diseases. Ionis achieved two FDA approvals, delivered three positive Phase 3 data readouts, expanded our rich Phase 3 pipeline to nine medicines and advanced our next wave of wholly owned medicines as well as our technology," said Brett P. Monia, Ph.D., chief executive officer of Ionis. "In 2024, we anticipate building on our success with important catalysts and continued value creation. The WAINUA U.S. launch is underway for patients with hereditary ATTR polyneuropathy, and we expect additional approvals in other countries this year. We plan to present positive Phase 3 data for olezarsen in familial chylomicronemia syndrome and donidalorsen in hereditary angioedema, positioning Ionis to independently launch these two medicines. We also anticipate additional readouts from multiple mid-stage programs that, if positive, would advance into Phase 3 development, further strengthening our ability to deliver a steady cadence of potentially transformational medicines for years to come."

Fourth Quarter and Full Year 2023 Summary Financial Results((1)):


                                                             Three months
                                                                 ended                    Year ended

                                                             December 31,                 December 31
                                                                                                  ,


                                                        2023           2022           2023          2022


                                                         
          (amounts in millions)



     Total revenue                                     $325           $152           $788          $587



     Operating expenses                                $331           $360         $1,141          $998



     Operating expenses on a non-GAAP basis            $305           $335         $1,035          $898



     Loss from operations                              ($6)        ($208)        ($353)       ($411)



     Income (Loss) from operations on a non-GAAP basis  $20         ($183)        ($247)       ($311)




     (1) Reconciliation of GAAP to non-GAAP basis contained later in this release.

Financial Highlights

    --  Revenue more than doubled for the fourth quarter of 2023 compared to the
        same period in the prior year and increased 34% for the full year,
        driven by the successful progression of Ionis' pipeline and technology
        platform
    --  Operating expenses increased compared to the prior year, primarily due
        to strategic investments to bring eplontersen, olezarsen and
        donidalorsen to patients
    --  2023 operating loss significantly improved over prior year due to
        substantial revenue earned during the year
    --  Cash and short-term investments of $2.3 billion as of December 31, 2023
        enables continued investments to drive increasing value, including
        supporting our potential upcoming launches

Recent Marketed Medicines Highlights

    --  WAINUA approved in the U.S., resulting in a $50 million milestone
        payment from AstraZeneca; launch underway for treatment of adults with
        polyneuropathy of hereditary transthyretin-mediated amyloidosis
        (ATTRv-PN)
    --  SPINRAZA continued to be the global market leader for the treatment of
        spinal muscular atrophy (SMA) with global sales of $1.7 billion in 2023

Recent Late-Stage Pipeline Highlights

    --  Eplontersen granted Fast Track designation by the FDA for the treatment
        of patients with ATTR cardiomyopathy (ATTR-CM)
    --  Olezarsen granted Breakthrough Therapy designation by the FDA for the
        treatment of patients with familial chylomicronemia syndrome (FCS)
    --  Olezarsen granted orphan drug designation by the FDA for the treatment
        of patients with FCS
    --  Achieved multiple milestones with donidalorsen for the treatment of
        patients with hereditary angioedema (HAE):
        --  Reported positive topline data from the Phase 3 OASIS-HAE study in
            patients treated every four weeks or every eight weeks; preparing to
            submit NDA
        --  Licensed European donidalorsen commercialization rights to Otsuka;
            Otsuka preparing to submit MAA
        --  Donidalorsen granted orphan drug designation by EMA
        --  Reported positive Phase 2 data from the open label extension study
            in patients with HAE treated for two years
    --  Bepirovirsen granted fast track designation by the FDA for the treatment
        of patients with chronic hepatitis B (CHB)

Recent Other Pipeline Highlights

    --  Achieved multiple milestones with ION582 (BIIB121) for the treatment of
        patients with Angelman syndrome:
        --  Completed enrollment in the Phase 1/2 HALOS study in patients with
            Angelman syndrome; on track for data readout in mid-2024
        --  Presented positive clinical update from ongoing HALOS study at the
            FAST (Foundation for Angelman Syndrome Therapeutics) Summit
        --  Extended the long-term extension portion of HALOS study
    --  Sapablursen and ION356 granted fast track designation by the FDA for the
        treatment of patients with polycythemia vera (PV) and
        Pelizaeus-Merzbacher disease (PMD), respectively
    --  Initiated the Phase 1/2 PrProfile study of ION717 in patients with Prion
        disease
    --  AstraZeneca licensed ION826 for the treatment of heart failure,
        resulting in a $36 million payment from AstraZeneca

Recent Technology Advancement Highlights

    --  Licensed Vect-Horus' blood-brain barrier crossing technology for the
        development of RNA-targeted neurological disease medicines

Fourth Quarter, Full Year 2023 Financial Results and 2024 Financial Guidance

"In 2023, we earned substantial revenues due to continued success with our pipeline and technology. As a result, we exceeded our 2023 revenue guidance, which drove a smaller than anticipated operating loss," said Elizabeth L. Hougen, chief financial officer of Ionis. "In 2024, with WAINUA's launch for ATTRv-PN underway, we are adding a new stream of royalty revenue to our substantial and sustained revenues. We will continue to deploy our capital resources toward growth opportunities that can enable Ionis to unlock next-level value. This includes continuing to make significant investments in near-term commercial opportunities, the expansion of our wholly owned pipeline, and advancing our technology, all of which should empower future growth."

Revenue

Ionis' revenue was comprised of the following:


                                                  Three months
                                                      ended                 Year ended


                                                  December 31,               December 31,


                                             2023         2022         2023      2022



     Revenue:                                     (amounts in millions)



          Commercial revenue:



     SPINRAZA royalties                      $62          $67         $240      $242



     Other commercial revenue:



     TEGSEDI and WAYLIVRA revenue, net         9            7           35        30



     Licensing and royalty revenue             8            6           34        31



     Total commercial revenue                 79           80          309       303



     Research and development revenue:



     Amortization from upfront payments       76           15          125        69



     Milestone payments                       11           14          101        74



     License fees                             92                      117        37



     Other services                                       22           10        27



     Collaborative agreement revenue         179           51          353       207



     WAINUA joint development revenue         67           21          126        77



     Total research and development revenue  246           72          479       284



     Total revenue                          $325         $152         $788      $587

Commercial revenues in 2023 were comparable to 2022. Commercial revenue for 2023 included $240 million from SPINRAZA royalties, which was comparable to 2022. Ionis' commercial revenue in 2023 also included royalties from QALSODY U.S. product sales.

R&D revenue significantly increased in 2023 compared to 2022 primarily due to continued success with Ionis' pipeline and technology. As a result, Ionis earned significant partner payments, including $50 million from AstraZeneca for the FDA approval of WAINUA for ATTRv-PN in the U.S., $36 million from AstraZeneca for licensing ION826 and payments from Ionis' new collaborations with Otsuka, Roche and Novartis.

Operating Expenses

Ionis' operating expenses increased for the year ended December 31, 2023 compared to 2022 primarily due to certain one-time costs, including a non-cash charge associated with a lease exit and the license fee Ionis paid to Vect-Horus. As Ionis advanced its robust pipeline, study costs increased compared to the same periods in 2022 as many of the Company's Phase 3 studies are either fully enrolled or approaching full enrollment, resulting in higher R&D expenses year over year. R&D expenses for the fourth quarter of 2023 were lower compared to the fourth quarter of 2022, primarily due to the $80 million upfront payment Ionis paid to Metagenomi in 2022. Ionis' SG&A expenses increased year over year primarily due to launch preparation activities for WAINUA, olezarsen and donidalorsen.

Balance Sheet

As of December 31, 2023, Ionis' cash, cash equivalents and short-term investments increased to $2.3 billion compared to $2.0 billion at December 31, 2022 primarily due to the $500 million Ionis received from Royalty Pharma in January 2023 and significant partner payments throughout 2023. Ionis' working capital also increased over the same period primarily due to the Company's higher cash and short-term investments balance. In 2023, the Company recorded a long-term liability for future royalties due to Royalty Pharma. In June 2023, Ionis issued $575 million of senior convertible notes due in June 2028 with an interest rate of 1.75%. The Company used the majority of the proceeds to repurchase $504 million of its 0.125% convertible notes.

2024 Financial Guidance

The Company's 2024 guidance reflects its plan to deploy its capital resources toward growth opportunities, including continued investments in its near-term commercial opportunities, expanding its wholly owned pipeline and advancing its technology platform. Additionally, the Company expects to continue earning substantial revenue from its commercial portfolio and partnered programs.



     Full Year 2024 Guidance



     Revenue                                           >$575
                                                         million



     Operating loss on a non-GAAP basis                <$475
                                                         million



     Cash, cash equivalents and short-term investments ~$1.7
                                                         billion

Webcast

Management will host a conference call and webcast to discuss Ionis' fourth quarter and full year 2023 results at 11:30 a.m. Eastern time on Wednesday, February 21, 2024. Interested parties may access the webcast here. A webcast replay will be available for a limited time at the same address. To access the Company's fourth quarter and full year 2023 earnings slides click here.

For more information about SPINRAZA and QALSODY, visit https://www.spinraza.com/ and https://www.qalsody.com/, respectively. QALSODY is approved under accelerated approval based on reduction in plasma neurofilament light chain (NfL) observed in patients treated with QALSODY. Continued approval may be contingent upon verification of clinical benefit in confirmatory trial(s).

INDICATION for WAINUA(TM) (eplontersen)
WAINUA injection, for subcutaneous use, 45 mg is indicated for the treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults.

IMPORTANT SAFETY INFORMATION for WAINUA(TM) (eplontersen)

WARNINGS AND PRECAUTIONS
Reduced Serum Vitamin A Levels and Recommended Supplementation WAINUA leads to a decrease in serum vitamin A levels. Supplement with recommended daily allowance of vitamin A. Refer patient to an ophthalmologist if ocular symptoms suggestive of vitamin A deficiency occur.

ADVERSE REACTIONS
Most common adverse reactions (>=9% in WAINUA-treated patients) were vitamin A decreased (15%) and vomiting (9%).

Please see link to U.S. Full Prescribing Information for WAINUA.

About Ionis Pharmaceuticals, Inc.

For three decades, Ionis has invented medicines that bring better futures to people with serious diseases. Ionis currently has five marketed medicines and a leading pipeline in neurology, cardiology, and other areas of high patient need. As the pioneer in RNA-targeted medicines, Ionis continues to drive innovation in RNA therapies in addition to advancing new approaches in gene editing. A deep understanding of disease biology and industry-leading technology propels our work, coupled with a passion and urgency to deliver life-changing advances for patients. To learn more about Ionis, visit Ionispharma.com and follow us on X (Twitter) and LinkedIn.

Ionis' Forward-looking Statement

This press release includes forward-looking statements regarding Ionis' business, financial guidance and the therapeutic and commercial potential of our commercial medicines, additional medicines in development and technologies. Any statement describing Ionis' goals, expectations, financial or other projections, intentions or beliefs is a forward-looking statement and should be considered an at-risk statement. Such statements are subject to certain risks and uncertainties including those inherent in the process of discovering, developing and commercializing medicines that are safe and effective for use as human therapeutics, and in the endeavor of building a business around such medicines. Ionis' forward-looking statements also involve assumptions that, if they never materialize or prove correct, could cause its results to differ materially from those expressed or implied by such forward-looking statements. Although Ionis' forward-looking statements reflect the good faith judgment of its management, these statements are based only on facts and factors currently known by Ionis. Except as required by law, we undertake no obligation to update any forward-looking statements for any reason. As a result, you are cautioned not to rely on these forward-looking statements. These and other risks concerning Ionis' programs are described in additional detail in Ionis' annual report on Form 10-K for the year ended December 31, 2022, and most recent Form 10-Q, which are on file with the Securities and Exchange Commission. Copies of these and other documents are available from the Company.

In this press release, unless the context requires otherwise, "Ionis," "Company," "we," "our" and "us" all refer to Ionis Pharmaceuticals and its subsidiaries.

Ionis Pharmaceuticals(®) is a registered trademark of Ionis Pharmaceuticals, Inc. Akcea Therapeutics(®) is a registered trademark of Akcea Therapeutics, Inc. TEGSEDI(®) is a registered trademark of Akcea Therapeutics, Inc. WAYLIVRA(®) is a registered trademark of Akcea Therapeutics, Inc. QALSODY(TM) is a trademark of Biogen. SPINRAZA(®) is a registered trademark of Biogen. WAINUA(TM )is a registered trademark of the AstraZeneca group of companies.


                                                     
              
                IONIS PHARMACEUTICALS, INC.

                                                    
              
                SELECTED FINANCIAL INFORMATION

                                           
              
                Condensed Consolidated Statements of Operations

                                                 
              
                (In Millions, Except Per Share Data)




                                                                                                                            Three months
                                                                                                                              ended,                   Year ended


                                                                                                                            December 31,                  December 31,


                                                                                                                      2023            2022            2023           2022


                                                                                                                           
              (unaudited)



     Revenue:



          Commercial revenue:



     SPINRAZA royalties                                                                                               $62             $67            $240           $242



     Other commercial revenue                                                                                          17              13              69             61



     Total commercial revenue                                                                                          79              80             309            303



     Research and development revenue:



     Collaborative agreement revenue                                                                                  179              51             353            207



     WAINUA joint development revenue                                                                                  67              21             126             77



     Total research and development revenue                                                                           246              72             479            284



     Total revenue                                                                                                    325             152             788            587



     Expenses:



            Cost of sales                                                                                               3               4               9             14



         Research, development and patent                                                                             257             308             900            833



         Selling, general and administrative                                                                           71              48             232            151




     Total operating expenses                                                                                         331             360           1,141            998



     Loss from operations                                                                                             (6)          (208)          (353)         (411)





     Other income (expense):



     Interest expense related to the sale of future royalties                                                        (18)                          (69)



     Gain on sale of real estate assets                                                                                              150                           150



     Other income (expense), net                                                                                       21              14              88              3



     Loss before income tax expense                                                                                   (3)           (44)          (334)         (258)





     Income tax expense                                                                                               (6)            (8)           (32)          (12)





     Net loss                                                                                                        ($9)          ($52)         ($366)        ($270)





     Basic and diluted net loss per share                                                                         ($0.06)        ($0.37)        ($2.56)       ($1.90)



     Shares used in computing basic and diluted net loss per share                                                    144             142             143            142


                                                                                   
              
                IONIS PHARMACEUTICALS, INC.

                                                                            
              
                Reconciliation of GAAP to Non-GAAP Basis:

                                                 
              
                Condensed Consolidated Operating Expenses, Income (Loss) From Operations, and Net Income (Loss)

                                                                                          
              
                (In Millions)




                                                                                                                                                                                Three months
                                                                                                                                                                                  ended             Year ended

                                                                                                                                                                                December 31            December 31
                                                                                                                                                                                      ,                    ,


                                                                                                                                                                           2023          2022     2023          2022


                                                                                                                                                                         
          (unaudited)



     
                
                  As reported research, development and patent expenses according to GAAP                                                                  $257          $308     $900          $833



         Excluding compensation expense related to equity awards                                                                                                          (20)         (19)    (78)         (74)



     
                
                  Non-GAAP research, development and patent expenses                                                                                       $237          $289     $822          $759





     
                
                  As reported selling, general and administrative expenses according to GAAP                                                                $71           $48     $232          $151



         Excluding compensation expense related to equity awards                                                                                                           (6)          (7)    (27)         (26)



     
                
                  Non-GAAP selling, general and administrative expenses                                                                                     $65           $41     $205          $125





     
                
                  As reported operating expenses according to GAAP                                                                                         $331          $360   $1,141          $998



     Excluding compensation expense related to equity awards                                                                                                              (26)         (25)   (106)        (100)



     
                
                  Non-GAAP operating expenses                                                                                                              $305          $335   $1,035          $898





     
                
                  As reported loss from operations according to GAAP                                                                                       ($6)       ($208)  ($353)       ($411)



         Excluding compensation expense related to equity awards                                                                                                          (26)         (25)   (106)        (100)



     
                
                  Non-GAAP income (loss) from operations                                                                                                    $20        ($183)  ($247)       ($311)





     
                
                  As reported net loss according to GAAP                                                                                                   ($9)        ($52)  ($366)       ($270)



         Excluding compensation expense related to equity awards and related tax effects                                                                                  (26)         (25)   (106)        (100)



         Excluding gain on sale of real estate assets*                                                                                                                                  150                   150



         Excluding income tax effect related to gain on sale of real estate assets                                                                                                      (9)                  (9)



     
                
                  Non-GAAP net income (loss)                                                                                                                $17        ($168)  ($260)       ($311)

*In October 2022, Ionis entered into a sale and leaseback transaction for several of its real estate assets. As a result, the Company recognized a $150 million gain on sale of real estate assets in the fourth quarter of 2022. The Company excluded the gain on sale of real estate assets and the related tax effect from its non-GAAP amounts for the applicable periods.

Reconciliation of GAAP to Non-GAAP Basis

As illustrated in the Selected Financial Information in this press release, non-GAAP operating expenses, non-GAAP income (loss) from operations, and non-GAAP net income (loss) were adjusted from GAAP to exclude compensation expense related to equity awards and the related tax effects. Compensation expense related to equity awards are non-cash. In 2022, Ionis' non-GAAP net loss excluded the gain on real estate assets related to the sale and leaseback transaction and the related tax effects. These measures are provided as supplementary information and are not a substitute for financial measures calculated in accordance with GAAP. Ionis reports these non-GAAP results to better enable financial statement users to assess and compare its historical performance and project its future operating results and cash flows. Further, the presentation of Ionis' non-GAAP results is consistent with how Ionis' management internally evaluates the performance of its operations.


                                    
              
                IONIS PHARMACEUTICALS, INC.

                               
              
                Condensed Consolidated Balance Sheets

                                           
              
                (In Millions)




                                                                                             December 31
                                                                                                       , December 31,


                                                                                                    2023          2022


                                                                                             (unaudited)



     Assets:



       Cash, cash equivalents and short-term investments                                         $2,331        $1,987



       Contracts receivable                                                                          98            26



       Other current assets                                                                         213           190



       Property, plant and equipment, net                                                            71            74



       Right-of-use assets                                                                          172           182



       Other assets                                                                                 105            75



          Total assets                                                                           $2,990        $2,534





     Liabilities and stockholders' equity:



       Current portion of deferred contract revenue                                                $151           $91



       0.125% convertible senior notes, net - short-term                                             44



       Other current liabilities                                                                    253           221



       1.75% convertible senior notes, net                                                          562



       0% convertible senior notes, net                                                             625           622



       0.125% convertible senior notes, net - long-term                                                          545



       Liability related to sale of future royalties, net                                           514



       Long-term lease liabilities                                                                  171           178



       Long-term obligations, less current portion                                                   42            16



       Long-term deferred contract revenue                                                          241           288



       Total stockholders' equity                                                                   387           573



         Total liabilities and stockholders' equity                                              $2,990        $2,534

Key 2024 Value Driving Events((1))



     
                
                  New Product Launches


                                  Program                                 Indication                                                   Achieved



     WAINUA                                            ATTRv-PN                                                                     --



     Olezarsen                              
              FCS


      QALSODY (EU)                                      SOD1-ALS





     
                
                  Regulatory Actions


                                  Program                                 Indication                               Regulatory Action   Achieved



     Eplontersen                                       ATTRv-PN                       Additional OUS filings                        --



     EMA approval decision



     Additional OUS approval decision(s)



     Olezarsen                              
              FCS                          
     NDA filing



     FDA approval decision



     EU filing



     Canada filing


      Donidalorsen                           
              HAE                          
     NDA filing



     QALSODY                                           SOD1-ALS                       EMA approval decision





     
                
                  Key Phase 3 Clinical Data Events


                                  Program                                 Indication                               Event               Achieved


      Donidalorsen                           
              HAE                            OASIS-HAE topline data                        --


      Donidalorsen                           
              HAE                          
     OASIS-HAE full data


      Donidalorsen                           
              HAE                            OASIS-Plus: OLE + Switch data



     Olezarsen                              
              FCS                            Balance study full data





     
                
                  Key Phase 2 Clinical Data Events


                                  Program                                 Indication                               Event               Achieved


      Donidalorsen                           
              HAE                          
     3-year OLE data


      IONIS-FB-LRx                           
              IgAN                         
     Phase 2 data


      IONIS-FB-LRx                           
              GA                           
     GOLDEN study data


      ION224 (DGAT2)                         
              NASH                         
     Phase 2 data


      ION582 (UBE3A)                                    Angelman syndrome            
     HALOS study data


      ION541 (ATXN2)                         
              ALS                          
     ALSpire study data




     (1) Timing expectations based on current assumptions and subject to change.

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SOURCE Ionis Pharmaceuticals, Inc.