AstraZeneca’s Wainua just missed the trial that was supposed to make it a $5 billion drug, and it’s dragging the company’s $80 billion 2030 target down with it.
I read the original approval file on this one. The FDA cleared eplontersen, sold as Wainua, on December 21, 2023, but only for polyneuropathy tied to hereditary transthyretin amyloidosis. The bigger indication, ATTR-CM cardiomyopathy, was always the real prize. On July 9, 2026, AstraZeneca and Ionis disclosed that the CARDIO-TTRansform trial missed its primary composite endpoint of cardiovascular death and recurrent events against placebo, across 1,432 patients.
Wainua brought in just $212 million last year. AstraZeneca had modeled peak sales above $5 billion once ATTR-CM reached the label. Strip that indication out and Leerink Partners’ 2030 revenue model for the company drops from $82.7 billion to $80.8 billion. Guggenheim cut its Wainua forecast from $2 billion to $500 million and pulled its own 2030 AstraZeneca estimate down to $78 billion.
The old yardstick had analysts converging comfortably above $80 billion as of this spring. The new one leans on two readouts still to come: SERENA-4 and AVANZAR. Leerink puts SERENA-4’s odds of success at just 20%. Slim odds.
CFO Aradhana Sarin maintains the $80 billion goal doesn’t assume any M&A, and that the company holds “substantial firepower” if the pipeline stumbles. Worth watching whether that firepower gets deployed before AstraZeneca reports second-quarter earnings on July 27.
Rebecca Lauren