Summary of Akebia Therapeutics, Inc. Q4 2025 Earnings Call

1Key Financial Results and Metrics

Q4 2025 Total Revenues: $57.6 million, up from $46.5 million in Q4 2024.

Full Year 2025 Total Revenues: $236.2 million, compared to $160.2 million in 2024.

Vafseo Net Product Revenue: $6.2 million in Q4 2025 and $45.8 million for the full year.

Auryxia Net Product Revenue: $48.1 million in Q4 2025, up from $44.4 million in Q4 2024; $181.5 million for the full year, compared to $152.2 million in 2024.

Net Loss: Decreased to $12.2 million in Q4 2025 from $22.8 million in Q4 2024; full-year net loss reduced to $5.3 million from $69.4 million.

Cash Position: Cash and cash equivalents stood at $184.8 million as of December 31, 2025.

2Strategic Updates and Business Highlights

Vafseo Launch: The commercial launch of Vafseo, an oral HIF-PH inhibitor, faced challenges in the second half of 2025 but showed signs of demand growth in Q4.

Clinical Data: Positive data presented at the ASN meeting indicated Vafseo's potential to lower hospitalization rates compared to ESAs, supporting its positioning as a standard of care.

Pipeline Expansion: Introduction of a rare kidney disease pipeline, including praliciguat and AKB-097, with plans for clinical trials in 2026 and 2027.

R&D Day Scheduled: An R&D Day is planned for April 2, 2026, to discuss mid-stage assets and provide insights into ongoing developments.

3Forward Guidance and Outlook

2026 Expectations: While specific revenue guidance for Vafseo was not provided, management expressed optimism for growth based on early Q1 data and improved prescriber access.

Clinical Trials: Anticipated results from the VOCAL study in Q4 2026 and the VOICE trial in early 2027, which are expected to support Vafseo's adoption.

Cost Savings Data: New data indicating significant cost savings associated with Vafseo treatment could enhance its market appeal.

4Bad News, Challenges, or Points of Concern

Demand Fluctuations: Vafseo's demand was slightly down in Q4 2025 due to a transition to an observed in-center dosing protocol, which led to a one-time inventory drawdown of approximately $4.8 million.

Auryxia Competition: Anticipation of increased generic competition for Auryxia in 2026, which is expected to negatively impact its revenue.

Adherence Issues: Although first refill adherence improved, ongoing challenges with patient adherence remain a concern, particularly in the context of chronic kidney disease management.

5Notable Q&A Insights

Growth Expectations: Management emphasized that growth in Vafseo sales would be steady rather than explosive, reflecting the complexities of the dialysis market.

Operationalization at DaVita: DaVita's integration of Vafseo is progressing, with a focus on educating physicians and implementing observed dosing protocols to improve adherence.

Clinical Data Impact: The upcoming clinical data from studies like VOICE and VOCAL are expected to significantly influence physician adoption and patient outcomes.

AKB-097 Protocol: The IND for AKB-097 is being reworked to simplify the protocol while maintaining its core elements, with activation pending finalization. Overall, Akebia Therapeutics is navigating a challenging launch environment for Vafseo while expanding its pipeline and managing financial performance effectively. The company remains optimistic about future growth driven by clinical data and strategic initiatives.