Vertex Pharmaceuticals Inc. (VRTX): To acquire CRNX; Adding a $5bn+ fifth pillar in endocrinology

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Vertex Pharmaceuticals Inc. (VRTX): To acquire CRNX; Adding a $5bn+ fifth pillar in endocrinology

ty of acromegaly patients (across pituitary centers

and community endocrinologists) and an estimated ~4,000 endocrinologists treat the

majority of adult and pediatric CAH patients. We expect VRTX to provide additional

details on synergy opportunities (in R&D etc.) following potential deal closure.

VRTX to acquire CRNX. VRTX announced that it has entered into a definitive agreement

with CRNX (covered by Richard Law), a commercial-stage biotech company focused on

the development and commercialization of novel therapeutics for rare endocrine

diseases. CRNX’s sole commercial asset is Palsonify (paltusotine), the first and only

once-daily oral therapy for adults with acromegaly (~20K/35K diagnosed US/ex-US

patients), which received FDA approval in September 2025 and recently received EMA

approval. For context, acromegaly is a rare hormonal disease most often caused by a

benign pituitary adenoma that leads to excess growth hormone. Surgery is the first-line

treatment, but only ~40-50% of patients achieve durable remission, with many needing

lifelong therapy. Somatostatin receptor ligands (SRLs) are used if surgery is unsuccessful,

however, traditional SRLs are large needle, intramuscular or deep subcutaneous

injectables, with the potential for breakthrough symptoms and low compliance, with

only ~18% of patients remaining on injectable SRLs at ~3 years. Palsonify, a selective

somatostatin receptor type 2 (SST2) nonpeptide agonist, is indicated for both SRL switch

and naïve patients per Ph3 data which achieved its primary endpoint of insulin-like

growth factor 1 level (IGF-1) less than or equal to the upper limit of normal (ULN; Exhibit

1).