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Akebia Turns to a Loss as Auryxia Recedes

The Tip Desk · August 5, 2026 · 3 min read

Vafseo net product sales reached $21.3 million in the second quarter, up 34% from the first quarter, as more than 10,500 patients were on therapy.

Akebia Therapeutics (AKBA), a biopharmaceutical company focused on kidney disease, reported a net loss of $8.9 million in the second quarter of 2026, compared with net income of $0.2 million a year earlier, as Auryxia sales fell and Vafseo’s sequential climb continued.

Total revenues were $49.1 million, down from $62.5 million in the second quarter of 2025. The company said the decline reflected lower Auryxia (ferric citrate) revenues, only partly offset by higher Vafseo sales.

Vafseo (vadadustat) net product revenues were $21.3 million, up 34% from $15.8 million in the first quarter of 2026. More than 10,500 patients were active on the drug in the second quarter, a 41% increase from the end of the first quarter. Prescribers rose to about 1,200, up roughly 17% from about 1,025 in the first quarter.

Auryxia net product revenues were $25.5 million, down from $47.2 million a year earlier. Akebia said it continues to expect Auryxia revenues to decrease in 2026 versus 2025 because of generic competition and pricing pressure. License, collaboration and other revenues were $2.4 million.

Cost of goods sold was $10.4 million. The company noted that Vafseo-related cost of goods sold in both periods came from pre-launch inventory that does not include the full cost of manufacturing, because some inventory-related expenses were recorded as research and development before U.S. approval.

Research and development expenses were $14.1 million, which the company attributed to increased clinical trial activity for praliciguat and ebribafusp and higher headcount-related costs. Selling, general and administrative expenses were $28.2 million, which it said was driven by higher commercialization-related activities. A $1.9 million restructuring expense related to a reorganization of the commercial organization also contributed to the swing to a loss.

In June, U.S. Renal Care and Akebia said a planned interim analysis of the VOICE trial (n=2,116) met predefined stopping criteria. The data showed a statistically significant improved safety outcome for Vafseo dosed three times per week versus erythropoiesis stimulating agents on a hierarchical composite endpoint of all-cause mortality and hospitalization (win odds 1.16; 95% CI 1.06, 1.28; p=0.0016), driven by a significant reduction in hospitalizations. Chief Executive Officer John P. Butler said the results marked an important step toward making Vafseo standard of care for anemia in patients on dialysis.

Akebia also said it initiated a Phase 2 open-label basket trial of ebribafusp, a next-generation complement inhibitor, in IgA nephropathy, lupus nephritis and C3 glomerulopathy, expected to enroll up to 30 patients with initial data in 2027. Enrollment continues in a Phase 2 trial of praliciguat in focal segmental glomerulosclerosis.

In June the company added an Orange Book–listed patent expiring June 2034 and eligibility for a five-year patent term extension on a composition-of-matter patent to mid-2032. The Vafseo portfolio now includes 14 Orange Book–listed patents with expirations out to 2036.

Cash and cash equivalents were about $155.5 million as of June 30, 2026, compared with $162.6 million as of March 31, 2026. Akebia said it believes existing cash, expected product, royalty, supply and license revenues, and a plan to refinance its senior secured term loan will fund its current operating plan for at least two years.

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