All Eyes on Vertex’s Kidney Franchise, as Painkiller Journavx Tops Half a Million Scripts
•February 13, 2026
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Why It Matters
Successful data from RAINIER could unlock a multi‑billion‑dollar market beyond cystic fibrosis, diversifying Vertex's revenue base. The trial’s outcome also determines the company’s competitive standing in the crowded IgAN space.
Key Takeaways
- •RAINIER trial shows no safety concerns, data due H1 2026
- •Povetacicept targets IgAN, gMG, membranous nephropathy
- •Competition intensifies with Otsuka's Voyxact and Vera's atacicept
- •Journavx sales fell 18%, limiting short‑term revenue boost
- •Vertex Q4 revenue $3.19B, 10% YoY growth
Pulse Analysis
Vertex’s RAINIER study represents a pivotal moment for the biotech as it seeks to translate its B‑cell‑modulating platform into a viable treatment for IgA nephropathy, a disease affecting roughly 30 million people worldwide. By focusing on the 24‑hour urine protein‑to‑creatinine ratio, the trial targets a clinically meaningful endpoint that regulators and payers scrutinize closely. If the interim data confirm the drug’s efficacy, Vertex can file a rolling approval using a priority‑review voucher, potentially accelerating market entry and establishing a foothold in a therapeutic area where few options exist.
The IgAN arena has become increasingly competitive after Otsuka secured FDA approval for its anti‑APRIL antibody Voyxact and Vera Therapeutics demonstrated a 46% proteinuria reduction with atacicept. These advances raise the bar for efficacy and safety, compelling Vertex to differentiate povetacicept through broader indications such as generalized myasthenia gravis and primary membranous nephropathy. Expanding the molecule’s label could create a “pipeline‑in‑a‑product” effect, allowing the company to amortize development costs across multiple indications and improve overall return on investment.
Financially, Vertex posted a solid $3.19 billion in Q4 revenue, buoyed by Trikafta’s $2.57 billion contribution, yet the modest performance of Journavx underscores the challenges of scaling non‑opioid pain therapeutics. While analysts expect incremental growth for Journavx in early 2026, the real upside hinges on the kidney franchise delivering robust data. A positive readout could not only diversify revenue away from cystic fibrosis but also position Vertex as a leader in B‑cell‑targeted therapies, enhancing its long‑term valuation and strategic flexibility.
All Eyes on Vertex’s Kidney Franchise, as Painkiller Journavx Tops Half a Million Scripts
Vertex Pharmaceuticals’ late‑stage study of povetacicept in IgA nephropathy has a “clean bill of health so far,” building up to a highly anticipated readout in the first half of this year as the biotech continues to slowly accrue sales for its non‑opioid analgesic Journavx.
Speaking to investors on Thursday to present the company’s full‑year 2025 earnings results, Vertex CEO and President Reshma Kewalramani could only reveal that the study, called RAINIER, is ongoing and is being monitored by an independent data board. “They have not asked us to change anything in the study,” she noted, which suggests that the trial is proceeding smoothly.
In November last year, Vertex announced that it had fully enrolled RAINIER, which is comparing povetacicept against placebo, looking primarily at 24‑hour urine protein‑to‑creatinine ratio (UPCR), a key measure of disease severity and progression. Data are expected in the first half of this year, which will allow Vertex to complete its rolling approval application with the FDA.
The biotech used a priority review voucher for this submission, according to Kewalramani.
“Povetacicept presents a significant opportunity for Vertex, which could be validated further by interim data in IgAN,” analysts at BMO Capital Markets wrote in an investor note after the company call on Thursday. In particular, the firm called the upcoming UPCR results “critical” for Vertex amid increasing competition in the IgAN space.
In November last year, for instance, Otsuka won the FDA’s nod for its anti‑APRIL antibody Voyxact. Following close behind—and posing another market challenge to Vertex—is Vera Therapeutics and its fusion protein atacicept, which in the same month demonstrated a 46 % reduction in proteinuria, according to a Phase 3 readout.
Beyond IgAN, Vertex is also positioning povetacicept as a “pipeline‑in‑a‑product for multiple B‑cell‑mediated diseases,” Kewalramani said, revealing that the company plans to expand the drug into neurology with a study in generalized myasthenia gravis (gMG).
“Expansion in gMG seems interesting,” BMO wrote on Thursday, “but competition has grown significant in recent years.” Vertex is also developing povetacicept for primary membranous nephropathy.
In the fourth quarter, Vertex made $3.19 billion in revenue, a 10 % year‑on‑year increase but a slim beat of the analyst consensus of $3.18 billion. Cystic fibrosis continued to be the company’s main money‑maker: Trikafta brought in $2.57 billion while Alfytrek made $380 million.
Sales for the company’s non‑opioid painkiller Journavx stalled at $26.7 million for the quarter, falling 18 % behind analyst forecasts. BMO doesn’t expect the painkiller to see explosive growth in the coming quarters, noting in its Thursday note that the product’s sales will most likely see an “incremental” increase in the first half of 2026.
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