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The first quarter of 2026 was relatively uneventful for Vertex Pharmaceuticals, which has delivered a largely expected print across its business that continues to be anchored by cystic fibrosis.
While some may regard this steady performance as “unremarkable,” analysts at BMO Capital Markets see it as consistency—and as a prelude to what could be an evolution of Vertex’s portfolio “that may be nothing short of iconic,” they wrote in a note to investors Monday evening.
In particular, the group pointed to Vertex’s fusion protein therapeutic povetacicept, for which the biotech has “recently” completed its rolling biologics application in IgA nephropathy (IgAN), according to itsQ1 earnings releaseon Monday. Vertex hasn’t yet announced a specific target action date for the asset, only noting that a decision should come six months after the FDA accepts the application.
In March, Vertex toplined Phase 3 data for povetacicept, touting a 49.8% reduction in proteinuria at 36 weeks, as compared with placebo. The trial, dubbed RAINIER, also hit a key secondary endpoint, showing a 79.3% decrease in serum galactose-deficient IgA1 levels versus placebo.
Analysts have consistently been bullish about povetacicept’s performance. BMO in a March 9 note said, “We continue to be encouraged by the strength of povetacicept’s data as Vertex works to build a new pillar of their business.” In its note on Monday, the analysts called RAINIER’s data “strong,” adding that they “remain confident in the asset’s differentiation.”
With these “differentiated” efficacy data and “well-tolerated profile,” Vertex’s goal is for povetacicept “to be physicians’ first choice for their IgAN patients,” Chief Commercial Officer Duncan McKechnie said during the company’s earnings call Monday afternoon.
Aside from IgAN, Vertex is also testing povetacicept for primary membranous nephropathy and generalized myasthenia gravis. The company is also beefing up its renal franchise with the Phase 3 asset inaxaplin for APOL1-mediated kidney disease and a Phase 2 asset VX-407 for autosomal dominant polycystic kidney disease.
Interim Phase 2/3 data for inaxaplin are slated for “early 2027,” according to BMO.
Together, these programs could rival and even surpass Vertex’s cystic fibrosis business and become the company’s cornerstone portfolio, CEO Reshma Kewalramani said on the earnings call. “The diseases that these medicines treat are rare diseases, but they are common rare diseases. And when you add them all up together, they are well into the hundreds of thousands of patients.”
In the first quarter, Vertex brought in $2.99 billion, up 8% from the same period in 2025. Cystic fibrosis continues to anchor the company’s revenue, growing 7% year-on-year to $1.78 billion. Newer products, however, including the non-opioid pain drug Journavx and the sickle cell disease gene therapy Casgevy, continued to struggle, with $29 million and $43 million in Q1 sales, respectively.