Two Part (Double-blind Inclisiran Versus Placebo [Year 1] Followed by Open-label Inclisiran [Year 2]) Randomized Multicenter Study to Evaluate Safety, Tolerability, and Efficacy of Inclisiran in Children (2 to Less Than 12 Years) With Homozygous Familial Hypercholesterolemia and Elevated LDL-cholesterol

This is a pivotal phase III study designed to evaluate safety, tolerability, and efficacy of inclisiran in children (aged 2 to <12 years) with homozygous familial hypercholesterolemia (HeFH) and elevated low density lipoprotein cholesterol (LDLC).

Start Date31 Mar 2025

Sponsor / Collaborator

Novartis Pharmaceuticals Corp.

NCT06597019 / Not yet recruitingPhase 3

Two Part (Double-blind Inclisiran Versus Placebo [Year 1] Followed by Open-label Inclisiran [Year 2]) Randomized Multicenter Study to Evaluate Safety, Tolerability and Efficacy of Inclisiran in Children (6 to Less Than 12 Years) With Heterozygous Familial Hypercholesterolemia and Elevated LDL- Cholesterol

This is a pivotal phase III study designed to evaluate safety, tolerability, and efficacy of inclisiran in children (aged 6 to <12 years) with heterozygous familial hypercholesterolemia (HeFH) and elevated low density lipoprotein cholesterol (LDLC).

Start Date31 Mar 2025

Sponsor / Collaborator

Novartis Pharmaceuticals Corp.

NCT06501443 / Not yet recruitingPhase 4

Latin America Lipid Optimization After Acute Event in Patients With AthErosclerotic CardiovasculaR DiseaSe and High LDL-C

This is an open label, patient-level 1:1 randomized clinical trial in a multi-country study aiming to evaluate the real-world impact of inclisiran + Usual Care (UC) vs UC alone on LDL-C lowering, patient-reported outcomes, and healthcare resource utilization in an in-hospital population of patients, admitted during the acute setting, stabilized and before discharge, following an acute cardiovascular event.

Start Date29 Nov 2024

Sponsor / Collaborator

Novartis Pharmaceuticals Canada, Inc.

100 Clinical Results associated with Inclisiran sodium

100 Translational Medicine associated with Inclisiran sodium

100 Patents (Medical) associated with Inclisiran sodium

210

Literatures (Medical) associated with Inclisiran sodium

01 Jan 2025·INTERNATIONAL JOURNAL OF CARDIOLOGY

Clinical reality and challenges with familial hypercholesterolemia patients' management. 2024 results from the Regional Center for Rare Diseases (RCRD) Registry in Poland

Article

Author: Rutkowska, Lena ; Lewek, Joanna ; Mierczak, Karina ; Bielecka-Dąbrowa, Agata ; Adach, Weronika ; Konopka, Agnieszka ; Gach, Agnieszka ; Starostecka, Ewa ; Banach, Maciej ; Sosnowska, Bożena

BACKGROUND:

Despite advancements in early diagnosis and effective medications in last decade, most heterozygous familial hypercholesterolemia (heFH) patients still fail to achieve their low-density lipoprotein cholesterol (LDL-C) goals and remain at residual cardiovascular disease risk. We present recent data from the regional FH registry in Poland, highlighting the challenges and real-life clinical management of FH patients.

METHODS:

The registry is held at the Regional Centre for Rare Diseases, founded in 2016, at the 2nd largest, supraregional hospital in Poland, where >80 different rare diseases in patients from all over Poland are diagnosed and treated, including phenotypically or genetically diagnosed FH patients. Our analysis focused on both children and adult FH patients, excluding those treated with inclisiran due to a small sample size (n = 5).

RESULTS:

We studied 173 consecutive heFH patients, median age for adult population was 40 years (range: 27-57), of whom 56.14 % were women. Among the population, 82.1 % were adults (n = 142), and 31 were children (17.92 %; median age 9 (8-13), females 58.16 %). Children exhibited lower total cholesterol and triglyceride levels compared to adults, with no significant differences in LDL-C and high-density lipoprotein cholesterol (HDL-C) levels. Molecular diagnosis in the whole population revealed that 76.6 % had an LDL receptor (LDLR) mutation, while 23.4 % had an apolipoprotein B (APOB) mutation. Risk assessment categorized patients into high (70.7 %), very high (22.1 %), and extremely high (7.1 %) risk groups. Triple therapy achieved treatment goals in 61.76 % of adults and 70.97 % of children. At baseline, 36.62 % of adult patients were not using statins. High-intensity statin therapy combined with ezetimibe was initiated for the remaining patients. Only 3.33 % of patients avoided statins due to complete intolerance. Ezetimibe was used in 57.27 % of patients (mostly in combination therapy), and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were prescribed for 28.17 % FH patients. In adults receiving statin and ezetimibe therapy, median achieved LDL-C was 141 mg/dl (107-184). For triple therapy, median achieved LDL-C was 52.5 mg/dL (32-86.5). Overall median achieved LDL-C in the study population was 99.5 mg/dl (57.5-145.4). PCSK9 inhibitors reduced LDL-C by 165.6 mg/dl. Combination therapy did not significantly alter baseline lipoprotein(a) (Lp(a)) levels (p = 0.134), and PCSK9 inhibitors led to a mean Lp(a) reduction of 18.66 mg/dl (45 % reduction; p = 0.013). Multivariable regression analysis identified key factors for achieving LDL-C targets in FH patients: DLCN total score, DLCN category, ezetimibe use, and PCSK9 inhibitors.

CONCLUSIONS:

In Poland, FH patients are often diagnosed too late (usually over 40 years of age), and many still do not reach their LDL-C goals. Combination LLT double or triple therapy significantly increases the likelihood of achieving LDL-C targets - even up to fivefold. Therefore, unrestricted access to PCSK9 inhibitors for all FH patients is crucial, without the current limitations imposed by drug reimbursement programs like B101.

22 Oct 2024·ANALYTICAL CHEMISTRY

An Accurate and Fast ³¹P qNMR Assay Method for Oligonucleotide Therapeutics

Article

Author: Li, Jiayi ; Chen, Kang ; Chen, Fu ; Kozak, Darby ; Wang, Yan ; Zhang, Deyi

Chemically modified nucleic acid molecules have been developed as oligonucleotide therapeutics, and its assay is critical in quality assurance. The common DNA/RNA quantification method using UV-260 nm can lack accuracy because of structure modifications and the possible formation of higher-order structure (HOS). Additionally, process-associated water and counterions affect the accuracy in gravimetric analysis. Thus, to improve accuracy, efficiency, and flexibility, in this work a fast (<1 h) externally referenced ³¹P quantitative-NMR (qNMR) method was developed. The qNMR assay results agreed within 1-5% of the UV-260 nm results for the single-stranded DNA standards, confirming the method accuracy. Next, an NMR and UV comparison study was performed on intact oligonucleotide drug products. The ³¹P qNMR method showed 7 ± 2%, 8 ± 1%, and 12 ± 1% lower concentration values compared with drug product labels for eteplirsen, inotersen, and inclisiran, respectively. Meanwhile the UV-260 nm results showed 28 ± 3%, 10 ± 3%, and 10 ± 1% lower concentrations than the label for the same three drugs. The agreement between NMR and UV for phosphorothioate (PS)-based inotersen and mostly phosphodiester (PO)-based inclisiran suggest that the labeled concentration may have been obtained using different extinction coefficients. The underestimate of UV results for eteplirsen, which has a phosphorodiamidate morpholino oligomer (PMO) structure, suggests that the UV-260 nm extinction coefficient may need to be re-established for the PMO based oligonucleotide. Therefore, the ³¹P qNMR method could be a primary assay method for the oligonucleotide drug and reference standard.

14 Oct 2024·CARDIOVASCULAR RESEARCH

ORION-8: one step closer to understanding the safety and efficacy of inclisiran

Article

Author: Tokgözoğlu, Lale ; Norata, Giuseppe Danilo

184

News (Medical) associated with Inclisiran sodium

31 Oct 2024

·www.businesswire.com

Alnylam Pharmaceuticals Reports Third Quarter 2024 Financial Results and Highlights Recent Period Activity

CAMBRIDGE, Mass.--( BUSINESS WIRE )-- Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY), the leading RNAi therapeutics company, today reported its consolidated financial results for the third quarter ended September 30, 2024 and reviewed recent business highlights. “ Alnylam continued to deliver robust results commercially and clinically in the third quarter. We achieved 34% year-over-year growth, with global net product revenues of $420 million, primarily driven by our TTR business. Further with TTR, we continued to share data for vutrisiran in ATTR-CM, with detailed HELIOS-B results presented at the European Society of Cardiology Congress, and supportive echocardiographic and biomarker data presented at the Heart Failure Society of America Annual Scientific Meeting 2024. We’re pleased to have submitted regulatory filings in the U.S. and EU, keeping us on track for a potential U.S. launch in early 2025 and other markets later in the year,” said Yvonne Greenstreet, MBChB, Chief Executive Officer of Alnylam. “ We also made great strides with our pipeline, sharing new results today from the Phase 1 study of mivelsiran in patients with Alzheimer’s disease and initiating a Phase 1 study for ALN-HTT02 in adult patients with Huntington’s disease earlier in the third quarter. With this execution, we have continued to progress toward achieving our Alnylam P 5 x25 goals and becoming a leading global biotech company.” Third Quarter 2024 and Recent Significant Business Highlights Commercial Performance Total TTR: ONPATTRO ® (patisiran) & AMVUTTRA ® (vutrisiran) Continued growth momentum in total TTR, achieving global net product revenues for ONPATTRO and AMVUTTRA for the third quarter of $50 million and $259 million, respectively, which combined represent 34% TTR annual growth compared to Q3 2023. Total Rare: GIVLAARI ® (givosiran) & OXLUMO ® (lumasiran) Achieved global net product revenues for GIVLAARI and OXLUMO for the third quarter of $71 million and $40 million, respectively, which combined represent 34% Rare annual growth compared to Q3 2023. R&D Highlights Presented detailed results from the positive HELIOS-B Phase 3 study of vutrisiran in patients with ATTR amyloidosis with cardiomyopathy (ATTR-CM) at the European Society of Cardiology Congress (ESC). Additional data from HELIOS-B, including echocardiographic and biomarker data, were presented at the Heart Failure Society of America Annual Scientific Meeting 2024 (HFSA). Based on these positive results, Alnylam submitted a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) using a Priority Review Voucher, as well as a Type II Variation to the European Medicines Agency (EMA), for vutrisiran for the treatment of ATTR amyloidosis with cardiomyopathy. Today announced positive initial results from the multiple dose portion of the Phase 1 study of mivelsiran in patients with Alzheimer’s disease. Following a second 50 mg dose of mivelsiran at month 6, further reductions of sAPPβ were observed at month 7, with patients achieving greater than 90% lowering of sAPPβ. No new safety signals have been identified, and no significant abnormalities have been seen on CSF safety labs such as total protein and CSF white cell count, or on the exploratory biomarker neurofilament light chain. Presented the design of the cAPPricorn-1 Phase 2 study of mivelsiran in patients with cerebral amyloid angiopathy (CAA) at the 2024 International CAA Conference. Initiated a Phase 1 study of ALN-HTT02 in adult patients with Huntington’s disease. Exon1 targeting strategy and design of the Phase 1 study were presented at the European Huntington's Disease Network (EHDN) & Enroll-HD 2024 Congress. Nonclinical data supporting the tolerability of deep and sustained HTT-lowering in wild-type nonhuman primates after single and repeated intrathecal administration of ALN-HTT02 were also shared. Today announced the decision to suspend further clinical development of ALN-KHK , an investigational RNAi therapeutic targeting ketohexokinase for the treatment of type 2 diabetes mellitus. This decision reflects portfolio prioritization efforts to allocate clinical, managerial and financial resources carefully to bring transformative medicines to patients. Additional Business Updates Alnylam hosted a TTR Investor Day featuring presentations from Alnylam senior leaders and an external expert related to the Company's TTR business. A replay of the webcast is available on the Company's website. Appointed Robert Hesslein as Chief Legal Officer and Corporate Secretary. Named one of Fast Company Top 100 Workplaces for Innovators in 2024. Recognized by Science magazine as a Top Employer for the sixth consecutive year. Upcoming Events Alnylam will present additional findings from the ongoing Phase 1 study of ALN-TTRsc04 in patients with ATTR amyloidosis at the American Heart Association Scientific Sessions 2024. The Company plans to share its Phase 3 development plan for ALN-TTRsc04 in the first quarter of 2025. Alnylam intends to initiate a Phase 2 study of mivelsiran in patients with Alzheimer’s disease at or around year-end. Financial Results for the Quarter Ended September 30, 2024 Three Months Ended September 30, (In thousands, except per share amounts) 2024 2023 Net product revenues $ 420,146 $ 313,153 Net revenue from collaborations $ 57,387 $ 427,472 Royalty revenue $ 23,386 $ 9,905 GAAP Operating (loss) income $ (76,905 ) $ 213,867 Non-GAAP Operating (loss) income $ (31,101 ) $ 277,804 GAAP Net (loss) income $ (111,570 ) $ 147,753 Non-GAAP Net (loss) income $ (64,199 ) $ 228,534 GAAP Net (loss) income per common share - basic $ (0.87 ) $ 1.18 Non-GAAP Net (loss) income per common share - basic $ (0.50 ) $ 1.83 GAAP Net (loss) income per common share - diluted $ (0.87 ) $ 1.15 Non-GAAP Net (loss) income per common share - diluted $ (0.50 ) $ 1.74 For an explanation of our use of non-GAAP financial measures refer to the “Use of Non-GAAP Financial Measures” section later in this press release and for a reconciliation of each non-GAAP financial measure to the most comparable GAAP measure, see the tables at the end of this press release. Net Product Revenues Three Months Ended September 30, Year over Year % Growth (In thousands, except percentages) 2024 2023 As Reported At CER* ONPATTRO net product revenues $ 50,293 $ 81,589 (38)% (38)% AMVUTTRA net product revenues 258,590 148,680 74% 75% Total TTR net product revenues 308,883 230,269 34% 35% GIVLAARI net product revenues 71,043 54,148 31% 31% OXLUMO net product revenues 40,220 28,736 40% 40% Total Rare net product revenues 111,263 82,884 34% 34% Total net product revenues $ 420,146 $ 313,153 34% 35% * CER = Constant Exchange Rate, representing growth calculated as if the exchange rates had remained unchanged from those used in the third quarter 2023. CER is a non-GAAP measure. Total net product revenues increased 34% and 35% at actual currency and CER, respectively, during the three months ended September 30, 2024, as compared to the same period in 2023, due to an increased number of patients receiving AMVUTTRA, GIVLAARI, and OXLUMO, partially offset by a decrease in patients receiving ONPATTRO primarily driven by switching to AMVUTTRA. Net Revenues from Collaborations Net revenues from collaborations decreased during the three months ended September 30, 2024, as compared to the same period in 2023, due to less revenue recognized under our collaborations with Roche and Regeneron. During 2023, we recognized $310 million of revenue from the upfront payment we received from Roche and a $65 million cumulative adjustment from the $100 million milestone we received in connection with our Regeneron Collaboration for achieving certain criteria during early clinical development for mivelsiran (formerly ALN-APP). Operating Expenses Three Months Ended September 30, (In thousands, except percentages) 2024 2023 Cost of goods sold $ 81,980 $ 79,473 Cost of goods sold as a percentage of net product revenues 19.5 % 25.4 % Cost of collaborations and royalties $ 3,925 $ 4,836 GAAP research and development expenses $ 270,926 $ 253,179 Non-GAAP research and development expenses $ 251,132 $ 224,024 GAAP selling, general and administrative expenses $ 220,993 $ 199,175 Non-GAAP selling, general and administrative expenses $ 194,983 $ 164,393 Cost of Goods Sold Cost of goods sold as a percentage of net product revenues decreased during the three months ended September 30, 2024, as compared to the same period in 2023, primarily due to higher costs in 2023 associated with cancelled manufacturing commitments and the impairment of ONPATTRO inventory that had been manufactured for future demand associated with the use of patisiran for the treatment of patients with ATTR amyloidosis with cardiomyopathy for which we did not receive regulatory approval in the U.S., offset by increased rate of royalties payable on net sales of AMVUTTRA. Research & Development (R&D) Expenses GAAP and non-GAAP R&D expenses increased during the three months ended September 30, 2024, as compared to the same period in 2023, primarily due to increased costs associated with our preclinical activities as we develop our clinical pipeline of RNAi therapeutics targeting multiple tissues, increased clinical trial expenses associated with increased Phase 2 activities for the zilebesiran KARDIA-3 clinical trial, and increased employee compensation expenses. Selling, General & Administrative (SG&A) Expenses GAAP and non-GAAP SG&A expenses increased during the three months ended September 30, 2024, as compared to the same period in 2023, primarily due to higher costs associated with marketing investments to promote our TTR therapies and prepare for the potential launch of AMVUTTRA for the treatment of ATTR amyloidosis with cardiomyopathy, and employee compensation. Other Financial Highlights Cash, cash equivalents and marketable securities were $2.78 billion as of September 30, 2024, as compared to $2.44 billion as of December 31, 2023, with the increase primarily due to improved operating performance and increased net proceeds from the issuance of common stock in connection with stock option exercises. A reconciliation of our GAAP to non-GAAP financial results for the quarter is included in the tables at the end of this press release. 2024 Financial Guidance Full year 2024 financial guidance is reiterated and consists of the following: Combined net product revenues for ONPATTRO, AMVUTTRA, GIVLAARI and OXLUMO 1 $1,575 million - $1,650 million Net Product Revenue Growth vs. 2023 at reported FX rates 1 27% to 33% Net Product Revenue Growth vs. 2023 at CER* 28% to 34% Net revenues from collaborations and royalties $575 million - $650 million GAAP R&D and SG&A expenses $2,000 million - $2,150 million Non-GAAP R&D and SG&A expenses 2 $1,775 million - $1,875 million 1 Uses June 30, 2024 FX rates including: 1 EUR = 1.07 USD and 1 USD = 161 JPY 2 Primarily excludes $225 - $275 million of stock-based compensation expense from estimated GAAP R&D and SG&A expenses *CER = Constant Exchange Rate, representing growth calculated as if the exchange rates had remained unchanged from those used in the twelve months ended December 31, 2023. CER is a non-GAAP measure. Use of Non-GAAP Financial Measures This press release contains non-GAAP financial measures, including expenses adjusted to exclude certain non-cash expenses and non-recurring gains outside the ordinary course of the Company’s business. These measures are not in accordance with, or an alternative to, GAAP, and may be different from non-GAAP financial measures used by other companies. The items included in GAAP presentations but excluded for purposes of determining non-GAAP financial measures for the periods presented in this press release are stock-based compensation expenses and realized and unrealized losses on marketable equity securities. The Company has excluded the impact of stock-based compensation expense, which may fluctuate from period to period based on factors including the variability associated with performance-based grants for stock options and restricted stock units and changes in the Company’s stock price, which impacts the fair value of these awards. The Company has excluded the impact of the realized and unrealized losses on marketable equity securities because the Company does not believe these adjustments accurately reflect the performance of the Company’s ongoing operations for the period in which such gains or losses are reported, as their sole purpose is to adjust amounts on the balance sheet. Percentage changes in revenue growth at CER are presented excluding the impact of changes in foreign currency exchange rates for investors to understand the underlying business performance. The current period’s foreign currency revenue values are converted into U.S. dollars using the average exchange rates from the prior period. The Company believes the presentation of non-GAAP financial measures provides useful information to management and investors regarding the Company’s financial condition and results of operations. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures, investors are provided with a more meaningful understanding of the Company’s ongoing operating performance and are better able to compare the Company’s performance between periods. In addition, these non-GAAP financial measures are among those indicators the Company uses as a basis for evaluating performance, allocating resources and planning and forecasting future periods. Non-GAAP financial measures are not intended to be considered in isolation or as a substitute for GAAP financial measures. A reconciliation between GAAP and non-GAAP measures is provided later in this press release. Conference Call Information Management will provide an update on the Company and discuss third quarter 2024 results as well as expectations for the future via conference call on Thursday, October 31, 2024 at 8:30 am ET. A live audio webcast of the call will be available on the Investors section of the Company’s website at www.alnylam.com/events . An archived webcast will be available on the Alnylam website approximately two hours after the event. About ONPATTRO ® (patisiran) ONPATTRO is an RNAi therapeutic that is approved in the United States and Canada for the treatment of adults with hATTR amyloidosis with polyneuropathy. ONPATTRO is also approved in the European Union, Switzerland and Brazil for the treatment of hATTR amyloidosis in adults with Stage 1 or Stage 2 polyneuropathy, and in Japan for the treatment of hATTR amyloidosis with polyneuropathy. ONPATTRO is an intravenously administered RNAi therapeutic targeting transthyretin (TTR). It is designed to target and silence TTR messenger RNA, thereby reducing the production of TTR protein before it is made. Reducing the pathogenic protein leads to a reduction in amyloid deposits in tissues. For more information about ONPATTRO, including full Prescribing Information , visit ONPATTRO.com . About AMVUTTRA ® (vutrisiran) AMVUTTRA (vutrisiran) is an RNAi therapeutic approved in the United States for the treatment of adults with hATTR amyloidosis with polyneuropathy. It is a double-stranded small interfering RNA (siRNA) that targets mutant and wild-type transthyretin (TTR) messenger RNA (mRNA). Using Alnylam’s Enhanced Stabilization Chemistry (ESC)-GalNAc-conjugate delivery platform, AMVUTTRA is designed for increased potency and high metabolic stability to allow for subcutaneous injection once every three months (quarterly). Results from the pivotal HELIOS-A Phase 3 study demonstrate AMVUTTRA rapidly reduces serum TTR levels, has the potential to reverse neuropathy impairment relative to baseline and improves other key measures of disease burden relative to external placebo in patients with the polyneuropathy of hATTR amyloidosis. For more information about AMVUTTRA, including the full U.S. Prescribing Information , visit AMVUTTRA.com . About GIVLAARI ® (givosiran) GIVLAARI (givosiran) is an RNAi therapeutic targeting aminolevulinic acid synthase 1 (ALAS1) approved in the United States and Brazil for the treatment of adults with acute hepatic porphyria (AHP). GIVLAARI is also approved in the European Union for the treatment of AHP in adults and adolescents aged 12 years and older. In the pivotal study, GIVLAARI was shown to significantly reduce the rate of porphyria attacks that required hospitalizations, urgent healthcare visits or intravenous hemin administration at home compared to placebo. GIVLAARI is Alnylam’s first commercially available therapeutic based on its Enhanced Stabilization Chemistry ESC-GalNAc conjugate technology to increase potency and durability. GIVLAARI is administered via subcutaneous injection once monthly at a dose based on actual body weight and should be administered by a healthcare professional. GIVLAARI works by specifically reducing elevated levels of ALAS1 messenger RNA (mRNA), leading to reduction of toxins associated with attacks and other disease manifestations of AHP. For more information about GIVLAARI, including the full U.S. Prescribing Information , visit GIVLAARI.com . About OXLUMO ® (lumasiran) OXLUMO (lumasiran) is an RNAi therapeutic targeting hydroxyacid oxidase 1 (HAO1). HAO1 encodes glycolate oxidase (GO). Thus, by silencing HAO1 and depleting the GO enzyme, OXLUMO inhibits production of oxalate – the metabolite that directly contributes to the pathophysiology of PH1. OXLUMO utilizes Alnylam’s Enhanced Stabilization Chemistry (ESC)-GalNAc-conjugate technology, which enables subcutaneous dosing with increased potency and durability and a wide therapeutic index. OXLUMO has received regulatory approvals from the U.S. Food and Drug Administration (FDA) for the treatment of primary hyperoxaluria type 1 (PH1) to lower urinary and plasma oxalate levels in pediatric and adult patients and from the European Medicines Agency (EMA) for the treatment of PH1 in all age groups. In the pivotal ILLUMINATE-A study, OXLUMO was shown to significantly reduce levels of urinary oxalate relative to placebo, with the majority of patients reaching normal or near-normal levels. In the ILLUMINATE-B pediatric Phase 3 study, OXLUMO demonstrated an efficacy and safety profile consistent to that observed in ILLUMINATE-A. In the ILLUMINATE-C study, OXLUMO resulted in substantial reductions in plasma oxalate in patients with advanced PH1. Across all three studies, injection site reactions (ISRs) were the most common drug-related adverse reaction. OXLUMO is administered via subcutaneous injection once monthly for three months, then once quarterly beginning one month after the last loading dose at a dose based on actual body weight. For patients who weigh less than 10 kg, ongoing dosing remains monthly. OXLUMO should be administered by a healthcare professional. For more information about OXLUMO, including the full U.S. Prescribing Information , visit OXLUMO.com . About LNP Technology Alnylam has licenses to Arbutus Biopharma lipid nanoparticle (LNP) intellectual property for use in RNAi therapeutic products using LNP technology. About RNAi RNAi (RNA interference) is a natural cellular process of gene silencing that represents one of the most promising and rapidly advancing frontiers in biology and drug development today. Its discovery has been heralded as “ a major scientific breakthrough that happens once every decade or so,” and was recognized with the award of the 2006 Nobel Prize for Physiology or Medicine. By harnessing the natural biological process of RNAi occurring in our cells, a new class of medicines known as RNAi therapeutics is now a reality. Small interfering RNA (siRNA), the molecules that mediate RNAi and comprise Alnylam’s RNAi therapeutic platform, function upstream of today’s medicines by potently silencing messenger RNA (mRNA) – the genetic precursors – that encode for disease-causing or disease pathway proteins, thus preventing them from being made. This is a revolutionary approach with the potential to transform the care of patients with genetic and other diseases. About Alnylam Pharmaceuticals Alnylam Pharmaceuticals (Nasdaq: ALNY) has led the translation of RNA interference (RNAi) into a whole new class of innovative medicines with the potential to transform the lives of people afflicted with rare and prevalent diseases with unmet need. Based on Nobel Prize-winning science, RNAi therapeutics represent a powerful, clinically validated approach yielding transformative medicines. Since its founding in 2002, Alnylam has led the RNAi Revolution and continues to deliver on a bold vision to turn scientific possibility into reality. Alnylam’s commercial RNAi therapeutic products are ONPATTRO ® (patisiran), AMVUTTRA ® (vutrisiran), GIVLAARI ® (givosiran), OXLUMO ® (lumasiran), and Leqvio ® (inclisiran), which is being developed and commercialized by Alnylam’s partner, Novartis. Alnylam has a deep pipeline of investigational medicines, including multiple product candidates that are in late-stage development. Alnylam is executing on its “ Alnylam P 5 x25 ” strategy to deliver transformative medicines in both rare and common diseases benefiting patients around the world through sustainable innovation and exceptional financial performance, resulting in a leading biotech profile. Alnylam is headquartered in Cambridge, MA. For more information about our people, science and pipeline, please visit www.alnylam.com and engage with us on X (formerly Twitter) at @Alnylam , or on LinkedIn , Facebook , or Instagram . Alnylam Forward Looking Statements This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. All statements other than historical statements of fact regarding Alnylam’s expectations, beliefs, goals, plans or prospects including, without limitation, statements regarding Alnylam’s expectations regarding the potential launch of AMVUTTRA for the treatment of ATTR amyloidosis with cardiomyopathy in the U.S. in early 2025 and in other countries later in 2025; Alnylam’s advancement towards its “Alnylam P 5 x25” strategy and aspiration to become a leading global biotech company; the potential for Alnylam to advance its research and development programs, including the timing of Alnylam’s presentation of data and sharing of the development plan for ALN-TTRsc04 and initiation of a Phase 2 clinical trial for mivelsiran in patients with Alzheimer’s Disease; and Alnylam’s projected commercial and financial performance, including the expected range of net product revenues and net revenues from collaborations and royalties for 2024, and the expected range of aggregate annual GAAP and non-GAAP R&D and SG&A expenses for 2024, should be considered forward-looking statements. Actual results and future plans may differ materially from those indicated by these forward-looking statements as a result of various important risks, uncertainties and other factors, including, without limitation, risks and uncertainties relating to: Alnylam’s ability to successfully execute on its “ Alnylam P 5 x25 ” strategy; Alnylam’s ability to discover and develop novel drug candidates and delivery approaches and successfully demonstrate the efficacy and safety of its product candidates; the pre-clinical and clinical results for Alnylam’s product candidates, including vutrisiran, zilebesiran, ALN-TTRsc04 and mivelsiran; actions or advice of regulatory agencies and Alnylam’s ability to obtain and maintain regulatory approval for its product candidates, including vutrisiran, as well as favorable pricing and reimbursement; successfully launching, marketing and selling Alnylam’s approved products globally; delays, interruptions or failures in the manufacture and supply of Alnylam’s product candidates or its marketed products; obtaining, maintaining and protecting intellectual property; Alnylam’s ability to successfully expand the approved indications for AMVUTTRA in the future; Alnylam’s ability to manage its growth and operating expenses through disciplined investment in operations and its ability to achieve a self-sustainable financial profile in the future without the need for future equity financing; Alnylam’s ability to maintain strategic business collaborations; Alnylam’s dependence on third parties for the development and commercialization of certain products, including Roche, Novartis, Sanofi, Regeneron and Vir; the outcome of litigation; the risk of future government investigations; and unexpected expenditures; as well as those risks and uncertainties more fully discussed in the “Risk Factors” filed with Alnylam’s 2023 Annual Report on Form 10-K filed with the Securities and Exchange Commission (SEC), as may be updated from time to time in Alnylam’s subsequent Quarterly Reports on Form 10-Q, and in other filings that Alnylam makes with the SEC. In addition, any forward-looking statements represent Alnylam’s views only as of today and should not be relied upon as representing its views as of any subsequent date. Alnylam explicitly disclaims any obligation, except to the extent required by law, to update any forward-looking statements. This release discusses investigational RNAi therapeutics and uses of previously approved RNAi therapeutics in development and is not intended to convey conclusions about efficacy or safety as to those investigational therapeutics or uses. Vutrisiran has not been approved by any regulatory agency for the treatment of ATTR amyloidosis with cardiomyopathy. No conclusions can or should be drawn regarding its safety or effectiveness in treating cardiomyopathy in this population. There is no guarantee that any investigational therapeutics or expanded uses of commercial products will successfully complete clinical development or gain health authority approval. ALNYLAM PHARMACEUTICALS, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (In thousands, except per share amounts) September 30, 2024 December 31, 2023 ASSETS (Unaudited) Current assets: Cash and cash equivalents $ 1,099,920 $ 812,688 Marketable debt securities 1,671,993 1,615,516 Marketable equity securities 8,322 11,178 Accounts receivable, net 353,852 327,787 Inventory 75,987 89,146 Prepaid expenses and other current assets 145,350 126,382 Total current assets 3,355,424 2,982,697 Property, plant and equipment, net 506,997 526,057 Operating lease right-of-use assets 196,408 199,732 Restricted investments 68,592 49,391 Other assets 77,618 72,003 Total assets $ 4,205,039 $ 3,829,880 LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT) Current liabilities: Accounts payable $ 70,805 $ 55,519 Accrued expenses 946,168 713,013 Operating lease liability 42,144 41,510 Deferred revenue 71,030 102,753 Liability related to the sale of future royalties 90,516 54,991 Total current liabilities 1,220,663 967,786 Operating lease liability, net of current portion 236,030 243,101 Deferred revenue, net of current portion 1,012 188,175 Convertible debt 1,023,654 1,020,776 Liability related to the sale of future royalties, net of current portion 1,333,849 1,322,248 Other liabilities 357,477 308,438 Total liabilities 4,172,685 4,050,524 Commitments and contingencies (Note 13) Stockholders’ equity (deficit): Preferred stock, $0.01 par value per share, 5,000 shares authorized and no shares issued and outstanding as of September 30, 2024 and December 31, 2023 — — Common stock, $0.01 par value per share, 250,000 shares authorized; 128,841 shares issued and outstanding as of September 30, 2024; 125,794 shares issued and outstanding as of December 31, 2023 1,289 1,259 Additional paid-in capital 7,259,876 6,811,063 Accumulated other comprehensive loss (24,826 ) (23,375 ) Accumulated deficit (7,203,985 ) (7,009,591 ) Total stockholders’ equity (deficit) 32,354 (220,644 ) Total liabilities and stockholders’ equity (deficit) $ 4,205,039 $ 3,829,880 This selected financial information should be read in conjunction with the consolidated financial statements and notes thereto included in Alnylam’s Annual Report on Form 10-K which includes the audited financial statements for the year ended December 31, 2023. ALNYLAM PHARMACEUTICALS, INC. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (In thousands, except per share amounts) (Unaudited) Three Months Ended Nine Months Ended September 30, 2024 September 30, 2023 September 30, 2024 September 30, 2023 Statements of Operations Revenues: Net product revenues $ 420,146 $ 313,153 $ 1,195,397 $ 895,186 Net revenues from collaborations 57,387 427,472 403,273 469,778 Royalty revenue 23,386 9,905 56,407 23,610 Total revenues 500,919 750,530 1,655,077 1,388,574 Operating costs and expenses: Cost of goods sold 81,980 79,473 203,864 196,241 Cost of collaborations and royalties 3,925 4,836 16,689 28,307 Research and development 270,926 253,179 826,063 732,274 Selling, general and administrative 220,993 199,175 680,187 597,523 Total operating costs and expenses 577,824 536,663 1,726,803 1,554,345 (Loss) income from operations (76,905 ) 213,867 (71,726 ) (165,771 ) Other (expense) income: Interest expense (34,376 ) (30,893 ) (102,887 ) (89,883 ) Interest income 32,146 25,425 90,973 65,155 Other expense, net (29,528 ) (57,658 ) (99,777 ) (105,331 ) Total other expense, net (31,758 ) (63,126 ) (111,691 ) (130,059 ) (Loss) income before income taxes (108,663 ) 150,741 (183,417 ) (295,830 ) Provision for income taxes (2,907 ) (2,988 ) (10,977 ) (6,542 ) Net (loss) income $ (111,570 ) $ 147,753 $ (194,394 ) $ (302,372 ) Net (loss) income per common share - basic $ (0.87 ) $ 1.18 $ (1.53 ) $ (2.43 ) Net (loss) income per common share - diluted $ (0.87 ) $ 1.15 $ (1.53 ) $ (2.43 ) Weighted-average common shares - basic 128,590 125,220 127,159 124,667 Weighted-average common shares - diluted 128,590 131,337 127,159 124,667 ALNYLAM PHARMACEUTICALS, INC. RECONCILIATION OF SELECTED GAAP MEASURES TO NON-GAAP MEASURES (In thousands, except per share amounts) (Unaudited) Three Months Ended September 30, 2024 September 30, 2023 Reconciliation of GAAP to Non-GAAP Research and development: GAAP Research and development $ 270,926 $ 253,179 Less: Stock-based compensation expenses (19,794 ) (29,155 ) Non-GAAP Research and development $ 251,132 $ 224,024 Reconciliation of GAAP to Non-GAAP Selling, general and administrative: GAAP Selling, general and administrative $ 220,993 $ 199,175 Less: Stock-based compensation expenses (26,010 ) (34,782 ) Non-GAAP Selling, general and administrative $ 194,983 $ 164,393 Reconciliation of GAAP to Non-GAAP Operating (loss) income: GAAP Operating (loss) income $ (76,905 ) $ 213,867 Add: Stock-based compensation expenses 45,804 63,937 Non-GAAP Operating (loss) income $ (31,101 ) $ 277,804 Reconciliation of GAAP to Non-GAAP Net (loss) income: GAAP Net (loss) income $ (111,570 ) $ 147,753 Add: Stock-based compensation expenses 45,804 63,937 Add: Realized and unrealized loss on marketable equity securities 1,567 16,844 Non-GAAP Net (loss) income $ (64,199 ) $ 228,534 Reconciliation of GAAP to Non-GAAP Net (loss) income per common share- basic: GAAP Net (loss) income per common share - basic $ (0.87 ) $ 1.18 Add: Stock-based compensation expenses 0.36 0.51 Add: Realized and unrealized loss on marketable equity securities 0.01 0.13 Non-GAAP Net (loss) income per common share - basic $ (0.50 ) $ 1.83 Reconciliation of GAAP to Non-GAAP Net (loss) income per common share- diluted: GAAP Net (loss) income per common share - diluted $ (0.87 ) $ 1.15 Add: Stock-based compensation expenses 0.36 0.49 Add: Realized and unrealized loss on marketable equity securities 0.01 0.13 Non-GAAP Net (loss) income per common share - diluted $ (0.50 ) $ 1.74 Please note that the figures presented above may not sum exactly due to rounding ALNYLAM PHARMACEUTICALS, INC. RECONCILIATION OF GAAP TO NON-GAAP PRODUCT REVENUE GROWTH AT CONSTANT CURRENCY (Unaudited) September 30, 2024 Three Months Ended ONPATTRO net product revenue growth, as reported (38 )% Add: Impact of foreign currency translation — ONPATTRO net product revenue growth at constant currency (38 )% AMVUTTRA net product revenue growth, as reported 74 % Add: Impact of foreign currency translation 1 AMVUTTRA net product revenue growth at constant currency 75 % Total TTR net product revenue growth, as reported 34 % Add: Impact of foreign currency translation 1 Total TTR net product revenue growth at constant currency 35 % GIVLAARI net product revenue growth, as reported 31 % Add: Impact of foreign currency translation — GIVLAARI net product revenue growth at constant currency 31 % OXLUMO net product revenue growth, as reported 40 % Add: Impact of foreign currency translation — OXLUMO net product revenue growth at constant currency 40 % Total net product revenue growth, as reported 34 % Add: Impact of foreign currency translation 1 Total net product revenue growth at constant currency 35 %

Clinical ResultPhase 3Phase 2Phase 1Drug Approval

29 Oct 2024

·www.globenewswire.com

Novartis continues strong momentum in Q3 with 10% sales growth, 20% core operating income growth, and important innovation milestones; raises FY 2024 guidance

Ad hoc announcement pursuant to Art. 53 LR Q3 net sales grew +10% (cc1, +9% USD) with core operating income up +20% (cc, +17% USD) Sales growth driven by continued strong performance from Entresto (+26% cc), Cosentyx (+28% cc), Kisqali (+43% cc), Kesimpta (+28% cc), Pluvicto (+50% cc) and Leqvio (+119% cc)Core operating income margin 40.1%, +340 basis points (cc), mainly driven by higher net sales Q3 operating income grew +123% (cc, +106% USD); net income up +121% (cc, +111% USD)Q3 core EPS grew +20% (cc, +18% USD) to USD 2.06Q3 free cash flow1 of USD 6.0 billion (+18% USD) driven by higher net cash flows from operating activitiesStrong nine months performance with sales up +11% (cc, +9% USD) and core operating income up +20% (cc, +17% USD)Q3 selected innovation milestones: Kisqali FDA approval and positive CHMP opinion for HR+/HER2- stage II and III eBC Fabhalta FDA accelerated approval for IgANPluvicto FDA filing for pre-taxane mCRPC Full-year 2024 guidance raised2 Net sales expected to grow low double-digit (from high single to low double-digit)Core operating income expected to grow high teens (from mid to high teens) Basel, October 29, 2024 – commenting on Q3 2024 results, Vas Narasimhan, CEO of Novartis, said: “Novartis delivered another quarter of strong operational performance in Q3, with sales up 10% and core operating income up 20%. All key growth drivers contributed to the momentum. We achieved important indications expansions for Kisqali in early breast cancer and Fabhalta in IgA nephropathy, and we completed our PSMAfore filing for Pluvicto in the US. With the momentum in our business and pipeline, we were able to once again upgrade our full-year guidance and remain highly confident in our mid-term outlook.” Key figuresContinuing operations3 Q3 2024Q3 2023% change9M 20249M 2023% change USD m USD mUSDcc USD m USD mUSDccNet sales12 82311 782910 37 16434 017911Operating income3 6271 762106123 11 0147 1875361Net income3 1851 513111121 9 1195 9345462EPS (USD)1.580.73116127 4.502.845867Free cash flow5 9655 04318 12 61811 01915 Core operating income5 1454 4051720 14 63512 5511720Core net income4 1333 5851517 11 82210 3201518Core EPS (USD)2.061.741820 5.834.951821 1. Constant currencies (cc), core results and free cash flow are non-IFRS measures. An explanation of non-IFRS measures can be found on page 46 of the Interim Financial Report. Unless otherwise noted, all growth rates in this Release refer to same period in prior year. 2. Please see detailed guidance assumptions on page 7. 3. As defined on page 35 of the Interim Financial Report, Continuing operations include the retained business activities of Novartis, comprising the innovative medicines business and the continuing corporate activities and Discontinued operations include operational results from the Sandoz business.StrategyOur focus In 2023, Novartis completed its transformation into a “pure-play” innovative medicines business. We have a clear focus on four core therapeutic areas (cardiovascular-renal-metabolic, immunology, neuroscience and oncology), with multiple significant in-market and pipeline assets in each of these areas, that address high disease burden and have substantial growth potential. In addition to two established technology platforms (chemistry and biotherapeutics), three emerging platforms (gene & cell therapy, radioligand therapy and xRNA) are being prioritized for continued investment into new R&D capabilities and manufacturing scale. Geographically, we are focused on growing in our priority geographies – the US, China, Germany and Japan. Our priorities Accelerate growth: Renewed attention to deliver high-value medicines (NMEs) and focus on launch excellence, with a rich pipeline across our core therapeutic areas.Deliver returns: Continuing to embed operational excellence and deliver improved financials. Novartis remains disciplined and shareholder-focused in our approach to capital allocation, with substantial cash generation and a strong capital structure supporting continued flexibility. Strengthening foundations: Unleashing the power of our people, scaling data science and technology and continuing to build trust with society. Financials Following the September 15, 2023, shareholder approval of the spin-off of Sandoz, Novartis reported its consolidated financial statements as “continuing operations” and “discontinued operations.” Continuing operations include the retained business activities of Novartis, comprising the innovative medicines business and the continuing corporate activities. Discontinued operations include the Sandoz Division and selected portions of corporate activities attributable to Sandoz’s business, as well as certain expenses related to the spin-off. While the commentary below focuses on continuing operations, we also provide information on discontinued operations. Continuing operations Third quarter Net sales were USD 12.8 billion (+9%, +10% cc), with volume contributing 12 percentage points to growth. Generic competition had a negative impact of 2 percentage points and pricing was flat. Operating income was USD 3.6 billion (+106%, +123% cc), mainly driven by lower impairments and higher net sales, partly offset by higher R&D investments. Net income was USD 3.2 billion (+111%, +121% cc), mainly driven by higher operating income. EPS was USD 1.58 (+116%, +127% cc), benefiting from the lower weighted average number of shares outstanding. Core operating income was USD 5.1 billion (+17%, +20% cc), mainly driven by higher net sales, partly offset by higher R&D investments. Core operating income margin was 40.1% of net sales, increasing 2.7 percentage points (+3.4 percentage points cc). Core net income was USD 4.1 billion (+15%, +17% cc), mainly due to higher core operating income. Core EPS was USD 2.06 (+18%, +20% cc), benefiting from the lower weighted average number of shares outstanding. Free cash flow from continuing operations amounted to USD 6.0 billion (+18% USD), compared with USD 5.0 billion in the prior-year quarter, driven by higher net cash flows from operating activities from continuing operations. Nine months Net sales were USD 37.2 billion (+9%, +11% cc) with volume contributing 14 percentage points to growth. Generic competition had a negative impact of 2 percentage points and pricing had a negative impact of 1 percentage point. Operating income was USD 11.0 billion (+53%, +61% cc), mainly driven by higher net sales, lower impairments and restructuring charges, partly offset by prior-year one-time income from legal matters and higher R&D investments. Net income was USD 9.1 billion (+54%, +62% cc), mainly driven by higher operating income. EPS was USD 4.50 (+58%, +67% cc), benefiting from the lower weighted average number of shares outstanding. Core operating income was USD 14.6 billion (+17%, +20% cc), mainly driven by higher net sales, partly offset by higher R&D investments. Core operating income margin was 39.4% of net sales, increasing 2.5 percentage points (+3.2 percentage points cc). Core net income was USD 11.8 billion (+15%, +18% cc), mainly due to higher core operating income. Core EPS was USD 5.83 (+18%, +21% cc), benefiting from the lower weighted average number of shares outstanding. Free cash flow from continuing operations amounted to USD 12.6 billion (+15% USD), compared with USD 11.0 billion in the prior-year period, driven by higher net cash flows from operating activities from continuing operations. Discontinued operations Discontinued operations include the Sandoz generic pharmaceuticals and biosimilars division, certain corporate activities attributable to Sandoz and certain other expenses related to the spin-off of the Sandoz business. Third quarter As the Sandoz spin-off was completed on October 3, 2023, there were no operating results in the third quarter of 2024 related to discontinued operations. In the third quarter of 2023, discontinued operations net sales were USD 2.5 billion, operating loss amounted to USD 86 million and net income from discontinued operations was USD 250 million. For further details see Note 3 “Significant acquisition of businesses and spin-off of Sandoz business” and Note 11 “Discontinued operations” to the condensed interim consolidated financial statements. Nine months As the Sandoz spin-off was completed on October 3, 2023, there were no operating results in the first nine months of 2024 related to discontinued operations. In the first nine months of 2023, discontinued operations net sales were USD 7.4 billion, operating income amounted to USD 265 million and net income from discontinued operations was USD 440 million. For further details see Note 3 “Significant acquisition of businesses and spin-off of Sandoz business” and Note 11 “Discontinued operations” to the condensed interim consolidated financial statements. Total Company Third quarter Total Company net income was USD 3.2 billion in 2024, compared to USD 1.8 billion in 2023 and basic EPS was USD 1.58 compared to USD 0.85 in prior year quarter. Net cash flows from operating activities for total Company amounted to USD 6.3 billion and free cash flow amounted to USD 6.0 billion. Nine months Total Company net income was USD 9.1 billion in 2024, compared to USD 6.4 billion in 2023 and basic EPS was USD 4.50 compared to USD 3.05 in prior year. Net cash flows from operating activities for total Company amounted to USD 13.4 billion and free cash flow amounted to USD 12.6 billion. Q3 key growth drivers Underpinning our financial results in the quarter is a continued focus on key growth drivers (ranked in order of contribution to Q3 growth) including: Entresto(USD 1 865 million, +26% cc) sustained robust, demand-led growth, with increased penetration in the US and Europe following guideline-directed medical therapy in heart failure, as well as in China with increased penetration in hypertensionCosentyx(USD 1 693 million, +28% cc) sales grew mainly in the US, Europe and emerging growth markets, driven by recent launches (including the HS indication and the IV formulation in the US) and volume growth in core indicationsKisqali(USD 787 million, +43% cc) sales grew strongly across all regions, based on increasing recognition of its overall survival benefit in HR+/HER2- advanced breast cancer and Category 1 NCCN guidelines recommendationKesimpta(USD 838 million, +28% cc) sales grew reflecting increased demand for a high efficacy product with convenient self-administered dosing; the prior-year period benefited from a one-time revenue deduction adjustment in EuropePluvicto(USD 386 million, +50% cc) sales grew in the US and Europe. Q3 sales benefited from a one-time revenue deduction adjustment in Europe. With supply now unconstrained, the focus is on increasing share in established RLT sites, while opening new sites and referral pathways, and initiating new patientsLeqvio(USD 198 million, +119% cc) continued to show steady growth, with a focus on increasing account and patient adoption, and continuing medical educationJakavi(USD 500 million, +18% cc) sales grew across all regions driven by strong demand across indicationsScemblix(USD 182 million, +72% cc) sales grew across all regions demonstrating the continued high unmet need in CMLTafinlar + Mekinist(USD 534 million, +12% cc) sales grew mainly in the US and emerging growth markets, driven by increased demandXolair(USD 418 million, +15% cc) grew mainly in emerging growth markets and EuropeFabhalta(USD 44 million) launch continues in PNH with an approval in IgAN in Q3Ilaris(USD 372 million, +12% cc) sales grew across all regions, led by the US and EuropeLutathera(USD 190 million, +19% cc) sales grew across all regions due to increased demand and earlier line adoption (within indication) in the US and Japan Emerging Growth Markets*Grew +12% (cc) overall. China grew +18% (cc) to USD 1.0 billion, mainly driven by Entresto, Cosentyx and Leqvio *All markets except the US, Canada, Western Europe, Japan, Australia, and New Zealand Net sales of the top 20 brands in the third quarter and nine months Q3 2024 % change9M 2024 % change USD mUSDccUSD mUSD ccEntresto1 86526265 6422830Cosentyx1 69327284 5452425Kesimpta- excl. PY revenue deduction adjust. 838 285528562 27449614962Kisqali 78740432 1314548Promacta/Revolade 569-101 633-4-3Tafinlar + Mekinist 53411121 53179Jakavi 50017181 4491416Tasigna 419-10-91 260-10-9Xolair 41813151 2441517Ilaris 37211121 0961216Pluvicto- excl. revenue deduction adjust. 38651375036 1 04147424742Sandostatin Group 305-10-8 973-3-1Zolgensma 30801 95234Lucentis 245-33-32 834-29-28Exforge Group 174-7-4 544-21Lutathera 1901919 5341717Leqvio 198120119 531129130Scemblix 1827272 4826769Galvus Group 159-12-6 458-15-8Diovan Group 150-22 450-31Top 20 brands total10 292171829 6041719 R&D update - key developments from the third quarter New approvals Kisqali(ribociclib)FDA approved Kisqali with a broad indication for HR+/HER2- stage II and III early breast cancer (eBC) at high risk of recurrence, approximately doubling the population eligible for CDK4/6 inhibitor adjuvant therapy, with the inclusion of those without nodal involvement. In addition, the CHMP issued a positive opinion for Kisqali in eBC in October. Fabhalta(iptacopan)FDA granted accelerated approval to Fabhalta for the reduction of proteinuria in adults with primary immunoglobulin A nephropathy (IgAN) at risk of rapid disease progression. Regulatory updates Pluvicto (lutetium Lu177 vipivotide tetraxetan)Completed FDA submission for Pluvicto pre-taxane mCRPC label expansion based on the positive Phase III PSMAfore study.Scemblix(asciminib)FDA granted Priority Review status to Scemblix for the treatment of newly diagnosed adult patients with Philadelphia chromosome-positive CML in chronic phase (Ph+ CML-CP). Scemblix is also under regulatory review in this indication in key international markets worldwide, including in China and Japan.Fabhalta(iptacopan)Submissions for the treatment of C3 glomerulopathy (C3G) completed in the EU, China and Japan. Results from ongoing trials and other highlights Kisqali(ribociclib)Results from a four-year post-hoc analysis of the pivotal Phase III NATALEE trial showed the addition of Kisqali to endocrine therapy (ET) in patients with stage II and III HR+/HER2- eBC reduced the risk of recurrence by 28.5% compared to ET alone. This invasive disease-free survival benefit was consistent across all pre-specified patient subgroups, including those with node-negative disease. Results were also consistent across secondary efficacy endpoints, with a trend for improvement in overall survival. Safety and tolerability remained consistent with previously reported results. Data presented at ESMO Congress 2024.Leqvio(inclisiran)In the Phase III V-MONO study, Leqvio demonstrated clinically meaningful and statistically significant low-density lipoprotein cholesterol (LDL-C) lowering versus both placebo and ezetimibe in patients who were at low or moderate risk of developing atherosclerotic cardiovascular disease (ASCVD) and not receiving lipid-lowering therapy. Novartis plans to present results from this trial at an upcoming medical meeting and share with regulatory agencies including FDA.Kesimpta(ofatumumab)Data from the ALITHIOS open-label extension study showed first-line Kesimpta treatment for up to six years led to less disability and disease progression in recently diagnosed (≤3 years) and treatment-naïve people with relapsing multiple sclerosis (RMS), compared to those who switched from teriflunomide.In the separate US-based single-arm OLIKOS Phase IIIb study, all clinically stable RMS patients who switched from intravenous anti-CD20 therapy to Kesimpta showed no new gadolinium-enhancing (Gd+) T1 lesions at 12 months. Data from both studies were presented at the ECTRIMS 2024 Annual Meeting.PelabresibBased on Novartis review of 48-week data from the Phase III MANIFEST-2 study, longer follow-up time is needed to determine, in consultation with Health Authorities, the regulatory path for pelabresib in myelofibrosis. We will continue to follow patients in MANIFEST-2 and evaluate the potential for additional studies to support registration. The 48-week data will be presented at an upcoming medical meeting.XXB750Novartis will not advance further development of XXB750 in resistant hypertension and heart failure, following current scientific assessment and review of available data from early investigational studies.BD&LNovartis, in collaboration with Versant Ventures, established Borealis Biosciences, an independent, discovery-stage biotechnology company focused on developing next-generation RNA-based medicines for kidney diseases. Under the agreement, Novartis has the option to acquire two future development-ready programs to augment its renal portfolio, a strategic area of focus for the company.Novartis entered into a collaboration agreement with Generate: Biomedicines to discover and develop protein therapeutics across multiple disease areas with generative AI. The collaboration will combine Generate’s AI platform with Novartis expertise and capabilities in target biology, biologics development, and clinical development to create novel therapeutics and to accelerate the pace of drug discovery and development. Capital structure and net debt Retaining a good balance between investment in the business, a strong capital structure, and attractive shareholder returns remains a priority. During the first nine months of 2024, Novartis repurchased a total of 52.7 million shares for USD 5.7 billion on the SIX Swiss Exchange second trading line. These purchases included 45.4 million shares (USD 4.8 billion) under the up-to USD 15 billion share buyback announced in July 2023 (with up to USD 7.9 billion still to be executed). In addition, 7.3 million shares (USD 0.9 billion) were repurchased to mitigate dilution related to participation plans of associates, with the remainder of repurchases for this purpose to be executed in Q4 2024. Further, 1.1 million shares (for an equity value of USD 0.1 billion) were repurchased from associates. In the same period, 9.1 million shares (for an equity value of USD 0.8 billion) were delivered as a result of share deliveries related to participation plans of associates. Consequently, the total number of shares outstanding decreased by 44.7 million versus December 31, 2023. These treasury share transactions resulted in an equity decrease of USD 5.0 billion and a net cash outflow of USD 5.5 billion. As of September 30, 2024, net debt increased to USD 16.3 billion compared to USD 10.2 billion net debt at December 31, 2023. The increase was mainly due to the free cash flow of USD 12.6 billion being more than offset by the USD 7.6 billion annual dividend payment, net cash outflow for M&A / intangible assets transactions of USD 5.5 billion, and cash outflow for treasury share transactions of USD 5.5 billion. As of Q3 2024, the long-term credit rating for the company is Aa3 with Moody’s Ratings and AA- with S&P Global Ratings. 2024 outlook Barring unforeseen events; growth vs prior year in ccPrevious guidanceNet salesExpected to grow low double-digit(from high single to low double-digit)Core operating incomeExpected to grow high teens(from mid to high teens) Key assumptions: We assume Tasigna, Promacta and Entresto US generic entry mid-2025 for forecasting purposes Foreign exchange impact If late-October exchange rates prevail for the remainder of 2024, the foreign exchange impact for the year would be negative 1 percentage point on net sales and negative 3 to negative 4 percentage points on core operating income. The estimated impact of exchange rates on our results is provided monthly on our website. Key figures1 Continuing operations2Q3 2024Q3 2023% change 9M 20249M 2023% change USD m USD mUSDcc USD m USD mUSDccNet sales12 82311 782910 37 16434 017911Operating income3 6271 762106123 11 0147 1875361As a % of sales28.315.0 29.621.1 Net income3 1851 513111121 9 1195 9345462EPS (USD)1.580.73116127 4.502.845867Cash flows from operating activities6 2865 30419 13 42611 67315 Non-IFRS measures Free cash flow 5 9655 04318 12 61811 01915 Core operating income5 1454 4051720 14 63512 5511720As a % of sales40.137.4 39.436.9 Core net income4 1333 5851517 11 82210 3201518Core EPS (USD)2.061.741820 5.834.951821 Discontinued operations2Q3 2024Q3 2023% change 9M 20249M 2023% change USD m USD mUSDcc USD m USD mUSDccNet sales 2 476nmnm 7 428nmnmOperating (loss)/income -86nmnm 265nmnmAs a % of sales -3.5 3.6 Net income 250nmnm 440nmnmNon-IFRS measures Core operating income 250nmnm 1 185nmnmAs a % of sales 10.1 16.0 Total CompanyQ3 2024Q3 2023% change 9M 20249M 2023% change USD m USD mUSDcc USD m USD mUSDccNet income3 1851 763nmnm 9 1196 374nmnmEPS (USD)1.580.85nmnm 4.503.05nmnmCash flows from operating activities6 2865 378nmnm 13 42611 911nmnmNon-IFRS measures Free cash flow 5 9655 043nmnm 12 61811 038nmnmCore net income4 1333 784nmnm 11 82211 209nmnmCore EPS (USD)2.061.83nmnm 5.835.37nmnm nm=not meaningful 1. Constant currencies (cc), core results and free cash flow are non-IFRS measures. An explanation of non-IFRS measures can be found on page 46 of the Interim Financial Report. Unless otherwise noted, all growth rates in this Release refer to same period in prior year.2. As defined on page 35 of the Interim Financial Report, Continuing operations include the retained business activities of Novartis, comprising the innovative medicines business and the continuing corporate activities and Discontinued operations include operational results from the Sandoz business. Detailed financial results accompanying this press release are included in the Interim Financial Report at the link below:https://ml-eu.globenewswire.com/resource/download/6504f5e3-a14c-43ba-8b72-44dcc5a45156/ DisclaimerThis press release contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995, that can generally be identified by words such as “may,” “can,” “will,” “continue,” “ongoing,” “grow,” “launch,” “expect,” “deliver,” “focus,” “address,” “accelerate,” “deliver,” “remain,” “scaling,” “guidance,” “outlook,” “long-term,” “priority,” “potential,” “momentum,” or similar expressions, or by express or implied discussions regarding potential new products, potential new indications for existing products, potential product launches, or regarding potential future revenues from any such products; or regarding results of ongoing clinical trials; or regarding potential future, pending or announced transactions; regarding potential future sales or earnings; or by discussions of strategy, plans, expectations or intentions, including discussions regarding our continued investment into new R&D capabilities and manufacturing; or regarding our capital structure; or regarding the consequences of the spin-off of Sandoz and our transformation into a “pure-play” innovative medicines company. Such forward-looking statements are based on the current beliefs and expectations of management regarding future events and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forth in the forward-looking statements. You should not place undue reliance on these statements. There can be no guarantee that the investigational or approved products described in this press release will be submitted or approved for sale or for any additional indications or labeling in any market, or at any particular time. Nor can there be any guarantee that such products will be commercially successful in the future. Neither can there be any guarantee expected benefits or synergies from the transactions described in this press release will be achieved in the expected timeframe, or at all. In particular, our expectations could be affected by, among other things: uncertainties regarding the success of key products, commercial priorities and strategy; uncertainties in the research and development of new products, including clinical trial results and additional analysis of existing clinical data; uncertainties regarding the use of new and disruptive technologies, including artificial intelligence; global trends toward healthcare cost containment, including ongoing government, payer and general public pricing and reimbursement pressures and requirements for increased pricing transparency; uncertainties regarding our ability to realize the strategic benefits, operational efficiencies or opportunities expected from our external business opportunities; our ability to realize the intended benefits of our separation of Sandoz into a new publicly traded standalone company; our ability to obtain or maintain proprietary intellectual property protection, including the ultimate extent of the impact on Novartis of the loss of patent protection and exclusivity on key products; uncertainties in the development or adoption of potentially transformational digital technologies and business models; uncertainties surrounding the implementation of our new IT projects and systems; uncertainties regarding potential significant breaches of information security or disruptions of our information technology systems; uncertainties regarding actual or potential legal proceedings, including regulatory actions or delays or government regulation related to the products and pipeline products described in this press release; safety, quality, data integrity, or manufacturing issues; our performance on and ability to comply with environmental, social and governance measures and requirements; major political, macroeconomic and business developments, including impact of the war in certain parts of the world; uncertainties regarding future global exchange rates; uncertainties regarding future demand for our products; and other risks and factors referred to in Novartis AG’s most recently filed Form 20-F and in subsequent reports filed with, or furnished to, the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements as a result of new information, future events or otherwise. All product names appearing in italics are trademarks owned by or licensed to Novartis. About Novartis Novartis is an innovative medicines company. Every day, we work to reimagine medicine to improve and extend people’s lives so that patients, healthcare professionals and societies are empowered in the face of serious disease. Our medicines reach more than 250 million people worldwide. Reimagine medicine with us: Visit us at https://www.novartis.com and connect with us on LinkedIn, Facebook, X/Twitter and Instagram. Novartis will conduct a conference call with investors to discuss this news release today at 14:00 Central European time and 9:00 Eastern Time. A simultaneous webcast of the call for investors and other interested parties may be accessed by visiting the Novartis website. A replay will be available after the live webcast by visiting https://www.novartis.com/investors/event-calendar. Detailed financial results accompanying this press release are included in the condensed interim financial report at the link below. Additional information is provided on our business and pipeline of selected compounds in late-stage development. A copy of today's earnings call presentation can be found at https://www.novartis.com/investors/event-calendar. Important dates November 20-21, 2024Meet Novartis Management 2024 (London, UK)December 9, 2024Impact & Sustainability annual investor event (virtual)January 31, 2025 Fourth quarter & full year 2024 results Please find full media release in English attached and on the following link:Media Release (PDF) Further language version is available through the following link: German version is available through the following link:Medienmitteilung (PDF)

Clinical ResultPhase 3Drug ApprovalFinancial StatementAccelerated Approval

17 Oct 2024

·www.biospace.com

Alnylam to Webcast Conference Call Discussing Third Quarter 2024 Financial Results

CAMBRIDGE, Mass.--(BUSINESS WIRE)-- Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY), the leading RNAi therapeutics company, announced today that it will report financial results for the third quarter ending September 30, 2024 on Thursday, October 31, 2024, before the U.S. financial markets open. Management will provide an update on the Company and discuss third quarter 2024 results as well as expectations for the future via conference call on Thursday, October 31, 2024 at 8:30 am ET. A live audio webcast of the call will be available on the Investors section of the Company’s website at . An archived webcast will be available on the Alnylam website approximately two hours after the event. About Alnylam Pharmaceuticals Alnylam (Nasdaq: ALNY) has led the translation of RNA interference (RNAi) into a whole new class of innovative medicines with the potential to transform the lives of people afflicted with rare and prevalent diseases with unmet need. Based on Nobel Prize-winning science, RNAi therapeutics represent a powerful, clinically validated approach yielding transformative medicines. Since its founding in 2002, Alnylam has led the RNAi Revolution and continues to deliver on a bold vision to turn scientific possibility into reality. Alnylam’s commercial RNAi therapeutic products are ONPATTRO ® (patisiran), AMVUTTRA ® (vutrisiran), GIVLAARI ® (givosiran), OXLUMO ® (lumasiran), and Leqvio ® (inclisiran), which is being developed and commercialized by Alnylam’s partner, Novartis. Alnylam has a deep pipeline of investigational medicines, including multiple product candidates that are in late-stage development. Alnylam is executing on its “ Alnylam P 5 x25 ” strategy to deliver transformative medicines in both rare and common diseases benefiting patients around the world through sustainable innovation and exceptional financial performance, resulting in a leading biotech profile. Alnylam is headquartered in Cambridge, MA. For more information about our people, science and pipeline, please visit and engage with us on X (formerly Twitter) at @Alnylam , on LinkedIn , or on Instagram . Contacts Alnylam Pharmaceuticals, Inc. Christine Regan Lindenboom (Investors and Media) 617-682-4340 Josh Brodsky (Investors) 617-551-8276

Financial StatementsiRNA

100 Deals associated with Inclisiran sodium

External Link

KEGG	Wiki	ATC	Drug Bank
-	Inclisiran sodium	C10AX	DB14901

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Hypercholesterolemia	JP	Novartis Pharma KK	25 Sep 2023
Primary Hyperlipidemia	US	Novartis Pharmaceuticals Corp.	07 Jul 2023
Atherosclerosis	AU	Novartis Pharmaceuticals Australia Pty Ltd.	14 Sep 2021
Heterozygous familial hypercholesterolemia	CA	Novartis Pharmaceuticals Canada, Inc.	26 Jul 2021
Hyperlipoproteinemia Type II	CA	Novartis Pharmaceuticals Canada, Inc.	26 Jul 2021
Dyslipidemias	EU	Novartis Europharm Ltd.	09 Dec 2020
Dyslipidemias	IS	Novartis Europharm Ltd.	09 Dec 2020
Dyslipidemias	LI	Novartis Europharm Ltd.	09 Dec 2020
Dyslipidemias	NO	Novartis Europharm Ltd.	09 Dec 2020
Primary hypercholesterolemia	EU	Novartis Europharm Ltd.	09 Dec 2020
Primary hypercholesterolemia	IS	Novartis Europharm Ltd.	09 Dec 2020
Primary hypercholesterolemia	LI	Novartis Europharm Ltd.	09 Dec 2020
Primary hypercholesterolemia	NO	Novartis Europharm Ltd.	09 Dec 2020

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Coronary Artery Disease	Phase 3	US	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	CN	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	JP	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	AR	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	AU	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	BE	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	BR	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	CA	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	CL	Novartis Pharmaceuticals Corp.	08 Jul 2022
Coronary Artery Disease	Phase 3	FR	Novartis Pharmaceuticals Corp.	08 Jul 2022

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05763875 (V-MONO, NEWS) Manual	Phase 3	Atherosclerosis	-	Leqvio	yyabklrcrn(ykueqgbxvx) = met its primary endpoints. hwgovealbd (urruirgwza ) Met	Positive	28 Aug 2024
				Ezetimibe
NCT03814187 (ORION-8, Pubmed)	Phase 2/3	Homozygous familial hypercholesterolemia \| Atherosclerosis \| Heterozygous familial hypercholesterolemia	3,274	Inclisiran	lcwkkkxusz(ddaizheuck) = 5.9% of inclisiran-treated patients rnnaqdcray (hypucdzaeq )	Positive	16 May 2024
NCT04929249 (V- INITIATE, PRNewswire) Manual	Phase 3	Atherosclerosis	450	Leqvio	vefhzxrnur(ibaejdnztq) = btlxokasdo mmqgrbmkyh (pqgkwlicpn ) View more	Positive	06 Apr 2024
NCT04807400 (SPIRIT, CTgov)	Phase 3	Hyperlipoproteinemias \| Atherosclerosis	892	Background lipid lowering therapy+Inclisiran (Inclisiran)	zfkgsgvkrp(tobzfoxysj) = hsuxlphqji rhaxohvxao (clpxuegbde, ecpgdnvvsd - fdgmvqjmim) View more	-	25 Mar 2024
				Behavioural Support+Inclisiran (Inclisiran + BS)	zfkgsgvkrp(tobzfoxysj) = kttpdkzxen rhaxohvxao (clpxuegbde, oqcotpqqtl - aqsuoslqcb) View more
NCT03851705 (ORION-5, Pubmed) Manual	Phase 3	Homozygous familial hypercholesterolemia	56	Inclisiran sodium	gzfpomcwmp(fwysgoltxg) = tnqldqczvm vzxshhuxon (pvoiftnjmk ) View more	Negative	30 Jan 2024
				Placebo	gzfpomcwmp(fwysgoltxg) = vjmlovbgqn vzxshhuxon (pvoiftnjmk ) View more
NCT03814187 (ORION-8, Corporate Publications) Manual	Phase 3	Atherosclerosis	3,274	inclisiran	imtgujedmr(znhcyztcdm) = dhrqvdbsco eborbtxrvf (zqpnkxnchy, 76.8 - 80.0) View more	Positive	28 Aug 2023
ESC2023	Not Applicable	First line	50	Group 2 (Switched from PCSK9 mAbs to Inclisiran)	vfdyrkhtpt(tdrnvsepyz) = During follow-up 6 patients (12%) reported side effects as abdominal complains, dizziness, fatigue and flu-like symptoms in the first week after administration phgxuvxyxv (jvcqdsmgtw ) View more	-	28 Aug 2023
Cholinet (ESC2023)	Phase 4	-	105	Inclisiran	jzxowixxdf(ldpkrbpnrw) = qtzhqjzeqg ymhanwnbpf (epiutkjnvs )	-	28 Aug 2023
NCT03400800 (ORION-11, FDA) Manual	Phase 3	Atherosclerosis	1,617	LEQVIO	zofnyhkulv(wcdrarsszw) = nedeegbcsm dbymfdwujo (yqxhckvtnb ) View more	Positive	07 Jul 2023
				Placebo	zofnyhkulv(wcdrarsszw) = mhlxmwgrsg dbymfdwujo (yqxhckvtnb ) View more
NCT03397121 (ORION-9, FDA) Manual	Phase 3	Heterozygous familial hypercholesterolemia	482	LEQVIO 284 mg	vnmdstctbc(oocuystjom) = wcxfltezto whcilpsszs (zfuxenfgjy ) View more	Positive	07 Jul 2023
				Placebo	vnmdstctbc(oocuystjom) = ueebyiagwd whcilpsszs (zfuxenfgjy ) View more

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