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The Cardiology Renaissance: Post CARDIO-TTransform, two top-of-mind catalysts remain for 3Q
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The Cardiology Renaissance: Post CARDIO-TTransform, two top-of-mind catalysts remain for 3Q
Goldman Sachs Global Healthcare: Pharmaceuticals
Framing two top-of-mind cardiology catalysts
Recall, AZN and IONS announced that the Phase 3 CARDIO-TTRansform study (n= 1,432)
of antisense oligonucleotide Wainua in ATTR-cardiomyopathy (CM) missed its primary
endpoint of the composite outcome of cardiovascular (CV) mortality and recurrent CV
clinical events assessed up to week 140 - while there was a nominally significant hazard
ratio of 0.71 in the monotherapy arm, there was no evidence of benefit in combination
with stabilizer therapy (e.g., PFE’s tafamidis), and tafamidis-treated patients performed
better-than-expected in the milder population.
The update was a negative surprise, as success on the primary endpoint was expected
per our investor discussions and the key debate centered on whether the stabilizer
combination group - 57% of patients with an additional 24% drop-in rate - would
achieve significance. We await full results at the European Society of Cardiology (ESC)
Congress in August.
After the CARDIO-TTRansform news, significant stock moves transpired for AZN (-10%),
IONS (-33%), and affected companies ALNY (-11%) and BBIO (+6%). On the forward, we
look to two other Phase 3 cardiovascular catalysts this quarter that could result in
volatility for the subject companies as well as wide-reaching effects for the field: (1)
NVS/IONS’ HORIZON trial of Lp(a)-targeting pelacarsen; and (2) NVO’s ZEUS assessing
ziltivekimab (IL-6). Below, we provide the set-up into the catalysts, including
benchmarks for success, readthrough to other affected companies, our implied up/down
moves, and options commentary.
Exhibit 1: Key cardiology catalysts in 2026 and 2027
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