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Ironwood Pharmaceuticals Inc.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 7 May 2026: press release. Guidance figures: 3 kept. The quarter’s numbers.

Key takeaways

  • Revenue more than doubled: Total revenue was $106.5 million, against $41.1 million a year earlier. It comprised $104.2 million of Ironwood's share of LINZESS U.S. net profits and $2.3 million of royalties and other revenue. Source
  • GAAP net income turned positive: GAAP net income was $40.8 million, or $0.24 per diluted share, against a GAAP net loss of $37.4 million, or $(0.23) per share, a year earlier. Source
  • Ironwood collaboration revenue up 169%: Ironwood recorded $104.2 million of collaboration revenue from U.S. LINZESS sales, against $38.8 million a year earlier. Of this, $103.9 million was Ironwood's share of net profit. Source
  • Net price and demand drove growth: LINZESS U.S. net sales growth came from 5% demand growth and significantly improved net price, according to the release. Source
  • Commercial margin rose to 76%: LINZESS commercial margin was 76% in Q1 2026, against 52% a year earlier. It is commercial profit on sales as a percent of total LINZESS U.S. net sales. Source
  • Convertible notes classed as current: Convertible senior notes were $199.9 million in current liabilities at March 31, 2026, with maturity in June. Source
  • STARS-2 trial design set: STARS-2 is planned as a confirmatory Phase 3 trial in SBS-IF. Its primary endpoint is relative change from baseline in actual weekly PS volume, with additional key secondary endpoints. Source

“driven by significantly improved net price and mid-single digit prescription growth for LINZESS, positioning us well to achieve our full-year 2026 financial guidance”

Tom McCourt, chief executive officer of Ironwood

Guidance

AreaPeriodFigureAgainst last quarter
U.S. LINZESS net sales SourceFull year 2026$1.125 - $1.175 billionKept
Total revenue SourceFull year 2026$450 - $475 millionKept
Adjusted EBITDA SourceFull year 2026>$300 millionKept

What changed from last quarter

  • Guidance kept: The three 2026 guidance items were kept from the February release; the company did not raise, lower, start or withdraw any in this release. Source
  • New: The sNDA for LINZESS in functional constipation (ages 2 to 5) was accepted with priority review; the February release did not include it. Source

Results and growth drivers

  • Revenue more than doubled: Total revenue was $106.5 million, against $41.1 million a year earlier. It comprised $104.2 million of Ironwood's share of LINZESS U.S. net profits and $2.3 million of royalties and other revenue. Source
  • GAAP net income turned positive: GAAP net income was $40.8 million, or $0.24 per diluted share, against a GAAP net loss of $37.4 million, or $(0.23) per share, a year earlier. Source
  • Adjusted EBITDA swung to profit: Adjusted EBITDA was $76.7 million, against negative $4.7 million a year earlier. It is GAAP net income less stock-based compensation, net restructuring, net interest, income taxes, and depreciation and amortization. Source
  • Non-GAAP net income also reported: Non-GAAP net income was $40.9 million, or $0.24 per diluted share, excluding amortization of acquired intangibles and net restructuring. Non-GAAP and GAAP diluted EPS are equal for the quarter. Source

U.S. LINZESS collaboration

  • AbbVie reports LINZESS net sales: AbbVie, the U.S. partner, provides LINZESS U.S. net sales to Ironwood. Ironwood and AbbVie share brand collaboration profits equally. Source
  • Brand net profit rose 211%: Net profit for the LINZESS U.S. brand collaboration, net of commercial and R&D expenses, was $204.7 million, against $65.9 million a year earlier. Source
  • Ironwood collaboration revenue up 169%: Ironwood recorded $104.2 million of collaboration revenue from U.S. LINZESS sales, against $38.8 million a year earlier. Of this, $103.9 million was Ironwood's share of net profit. Source
  • Reimbursement for expenses fell: Reimbursement for Ironwood's commercial expenses was $0.3 million, down from $3.0 million, which the company ties to the strategic reorganization announced in January 2025. Source

“which will help support repayment of our 2026 convertible notes at maturity in June”

Tom McCourt, chief executive officer of Ironwood

Pricing, margin and demand

  • Net price and demand drove growth: LINZESS U.S. net sales growth came from 5% demand growth and significantly improved net price, according to the release. Source
  • Rebate changes lifted net price: The improved net price reflects elimination of inflationary rebates and favorable timing of gross-to-net rebate reserves in Q1 2026 compared with Q1 2025. Source
  • Commercial margin rose to 76%: LINZESS commercial margin was 76% in Q1 2026, against 52% a year earlier. It is commercial profit on sales as a percent of total LINZESS U.S. net sales. Source
  • Prescription demand up 5%: Total LINZESS prescription demand was 56.0 million capsules in Q1 2026, per IQVIA. The CEO described prescription growth as mid-single digit. Source

Costs and expenses

  • Total costs fell year over year: Total costs and expenses were $33.9 million, against $70.3 million in Q1 2025, when restructuring expense was $18.6 million. Source
  • R&D and SG&A spend lower: R&D expenses were $21.9 million, against $27.4 million a year earlier. SG&A expenses were $12.0 million, against $24.3 million. Source
  • Restructuring near zero: Restructuring was a reversal of an insignificant amount in Q1 2026, against $18.6 million of expense in Q1 2025. Source
  • Interest expense higher: Interest expense was $9.1 million, up from $8.1 million, tied to the convertible senior notes and the revolving credit facility. Source

“We remain on track for site initiation for the confirmatory STARS-2 Phase 3 clinical trial in the second quarter”

Michael Shetzline, chief medical officer, senior vice president and head of research and drug development at Ironwood

Cash, debt and tax

  • Cash balance rose: Cash and cash equivalents were $220.5 million at March 31, 2026, up from $215.5 million at December 31, 2025. Source
  • Operating cash flow lower: Cash from operations was $5.1 million in Q1 2026, against $20.0 million in Q1 2025. Accounts receivable rose to $105.8 million from $46.7 million at year-end, mainly from Q1 collaboration revenue. Source
  • Convertible notes classed as current: Convertible senior notes were $199.9 million in current liabilities at March 31, 2026, with maturity in June. Source
  • Revolver balance held at $385.0 million: Principal on the revolving credit facility was $385.0 million at March 31, 2026, the same as at December 31, 2025. Source
  • Tax expense mostly non-cash: Income tax expense was $24.4 million, mostly non-cash, because net operating losses still offset taxable income for federal purposes and in many states. Source

Apraglutide and regulatory milestones

  • STARS-2 trial design set: STARS-2 is planned as a confirmatory Phase 3 trial in SBS-IF. Its primary endpoint is relative change from baseline in actual weekly PS volume, with additional key secondary endpoints. Source
  • Pooled STARS data at DDW: At the 2026 Digestive Disease Week in May, Ironwood presented pooled STARS data, including the Phase 2 Nutrition study, the Phase 3 placebo-controlled study and the open-label STARS Extend study. The company reports the safety profile matched earlier studies. Source
  • Long-term data on enteral autonomy: Management described long-term data as showing enteral autonomy outcomes, with reductions in parenteral support over time. Source
  • Once-weekly dosing cited by management: Management believes apraglutide's once-weekly dosing could redefine the standard of care in SBS-IF. Source
  • Priority review granted for ages 2 to 5: The FDA accepted the LINZESS sNDA for functional constipation in patients aged 2 to 5 and granted priority review. Source

Coming up, as management said on 7 May 2026

  • STARS-2 sites open in Q2: Ironwood expects to begin initiating clinical sites in Q2 2026 for STARS-2, the confirmatory Phase 3 trial of apraglutide in SBS-IF. Source
  • FDA action date May 24: The FDA set a PDUFA date of May 24 for the LINZESS sNDA covering patients aged 2 to 5 with functional constipation. Source
  • Convertible notes repaid at June maturity: Management expects Q2 2026 operating cash flows to support repayment of the convertible notes when they mature in June. Source

Figures management reported

FigureReported
LINZESS U.S. net sales Source$272.5 million, up 97%
LINZESS prescription demand (IQVIA) Source56.0 million capsules, up 5%
LINZESS commercial margin Source76% (Q1 2025: 52%)
R&D expense Source$21.9 million (Q1 2025: $27.4 million)
LINZESS sNDA (functional constipation, ages 2 to 5) SourcePDUFA date May 24
Apraglutide pooled STARS safety data SourceConsistent with previous studies

Earlier plans management reported on

  • On track: Management says the STARS-2 site initiation remains on track for the second quarter. Source
  • Not stated: The CEO says Q1 positions the company to achieve its full-year 2026 guidance; no further status is given. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.