Ironwood raises 2026 guidance again as apraglutide trial recruits and debt is repaid

Ironwood Pharmaceuticals reported second quarter 2026 results on August 6, 2026, raising its full-year guidance for a second consecutive quarter. The company said it initiated and is actively recruiting patients for STARS-2, a confirmatory Phase 3 clinical trial of apraglutide for patients with SBS-IF dependent on parenteral support, a severe chronic malabsorptive condition.¹ The study is a 24-week global, randomized, double-blind, placebo-controlled trial with a primary endpoint of relative change from baseline in actual weekly PS volume.¹ Secondary endpoints at week 24 include clinical response, defined as a 20% reduction in PS volume, number of days of PS per week, and enteral autonomy.¹

On regulatory matters, in May 2026 the FDA approved LINZESS in pediatric patients 2 years of age and older with functional constipation, and LINZESS remains the only FDA-approved prescription therapy for pediatric FC.¹

In leadership, Dr. Jeffrey Silber took over in July as Ironwood's chief medical officer and head of research and drug development, a role that opened after the retirement of Dr. Michael Shetzline.¹

Ironwood raised its 2026 outlook, now projecting U.S. LINZESS net sales of $1.15 to $1.20 billion, up from a prior range of $1.125 to $1.175 billion, total revenue of $460 to $485 million versus $450 to $475 million previously, and adjusted EBITDA above $310 million compared with above $300 million before.¹ The updated sales outlook is driven by improved net price and mid-single digit percentage demand growth, up from an assumption of low-single digit demand growth in the prior guidance.¹

On the balance sheet, Ironwood paid off in full the $200 million principal balance of its 1.50% convertible senior notes at their scheduled maturity in June 2026, using cash it had on hand.¹ The company ended the quarter with $79.1 million in cash and cash equivalents, down from $215.5 million at the end of 2025.¹ Its revolving credit facility carried an outstanding balance of $385.0 million as of June 30, 2026, with $165.0 million of remaining borrowing capacity.¹