BOSTON, MA — May 7, 2026 — Leads & Copy —
Ironwood Pharmaceuticals, Inc. (Nasdaq: IRWD) reported its first quarter 2026 financial results, highlighting strong financial performance and progress in its clinical programs.
The biotechnology company, which focuses on developing and commercializing therapies for gastrointestinal (GI) and rare diseases, announced that first quarter revenue reached $106.5 million, a significant increase from $41.1 million in the same period last year. This growth was primarily driven by improved net price and mid-single digit prescription growth for LINZESS.
Ironwood’s Chief Executive Officer, Tom McCourt, stated that the company is well-positioned to achieve its full-year 2026 financial guidance. He also noted that the strong first-quarter revenue is expected to generate substantial operating cash flows in the second quarter, which will support the repayment of the company’s 2026 convertible notes at maturity in June.
The company’s pipeline also saw progress, with the confirmatory STARS-2 Phase 3 clinical trial expected to begin site initiation in the second quarter. Michael Shetzline, chief medical officer, senior vice president and head of research and drug development at Ironwood, expressed optimism about apraglutide, stating that the company believes it has the potential to redefine the standard of care in SBS-IF (short bowel syndrome with intestinal failure). Data generated to date shows compelling enteral autonomy outcomes, with rapid and sustained reductions in parenteral support over time.
In January 2026, the FDA accepted and granted priority review of a supplemental New Drug Application (sNDA) for LINZESS for the treatment of functional constipation (FC) in patients 2 to 5 years of age. The FDA assigned a Prescription Drug User Fee Act (PDUFA) date of May 24th.
Total LINZESS prescription demand in the first quarter of 2026 was 56.0 million LINZESS capsules, a 5% increase compared to the first quarter of 2025, per IQVIA.
LINZESS U.S. net sales were $272.5 million in the first quarter of 2026, a 97% increase compared to $138.5 million in the first quarter of 2025. Ironwood and AbbVie share equally in U.S. brand collaboration profits.
Q1 2026 LINZESS U.S. net sales growth year-over-year was driven by 5% demand growth and significantly improved net price due to elimination of inflationary rebates and favorable time-phasing of gross-to-net rebate reserves in the first quarter of 2026 relative to 2025.
LINZESS commercial margin was 76% in the first quarter of 2026, compared to 52% in the first quarter of 2025.
Net profit for the LINZESS U.S. brand collaboration, net of commercial and research and development (“R&D”) expenses, was $204.7 million in the first quarter of 2026, a 211% increase compared to $65.9 million in the first quarter of 2025.
Ironwood recorded $104.2 million in collaboration revenue in the first quarter of 2026 related to sales of LINZESS in the U.S., a 169% increase compared to $38.8 million for the first quarter of 2025.
Ironwood is advancing apraglutide for short bowel syndrome (“SBS”) patients dependent on parenteral support (“PS”), a severe chronic malabsorptive condition. Ironwood believes apraglutide has the potential to improve the standard of care for adult patients with SBS who are dependent on PS as the first and only GLP-2 to achieve a statistically significant reduction in weekly PS volume with once-weekly administration.
STARS-2 is planned to be a 24-week global, randomized, double-blind, placebo-controlled trial. The primary endpoint is relative change from baseline in actual weekly PS volume, with additional key secondary endpoints also planned.
In May, during the 2026 Digestive Disease Week (DDW), Ironwood presented data pooled from the STARS clinical program – including the Phase 2 STARS Nutrition study, STARS Phase 3 randomized placebo-controlled study, and the ongoing open-label extension study STARS Extend – apraglutide showed a safety profile consistent with previous studies.
Total costs and expenses in the first quarter of 2026 were $33.9 million, compared to $70.3 million in the first quarter of 2025.
GAAP net income was $40.8 million, or $0.25 per share (basic) and $0.24 per share (diluted) in the first quarter of 2026, compared to GAAP net loss of $37.4 million, or ($0.23) per share (basic and diluted) in the first quarter of 2025.
Adjusted EBITDA was $76.7 million in the first quarter of 2026, compared to ($4.7) million in the first quarter of 2025.
Ironwood ended the first quarter of 2026 with $220.5 million of cash and cash equivalents, compared to $215.5 million of cash and cash equivalents at the end of 2025.
The outstanding principal balance on the revolving credit facility was $385.0 million as of March 31, 2026.
Ironwood generated $5.1 million in cash from operations in the first quarter of 2026, compared to $20.0 million in cash from operations in the first quarter of 2025.
Ironwood had $105.8 million in accounts receivable as of March 31, 2026, primarily related to first quarter 2026 collaboration revenues.
Ironwood continues to expect U.S. LINZESS Net Sales of $1.125 – $1.175 billion and Total Revenue of $450 – $475 million, driven by improved net price and low-single digit percentage demand growth.
Ironwood expects Adjusted EBITDA to be greater than $300 million.
Ironwood Pharmaceuticals (Nasdaq: IRWD) is a biotechnology company developing and commercializing life-changing therapies for people living with gastrointestinal (GI) and rare diseases.
LINZESS® (linaclotide) is the #1 prescribed brand in the U.S. for the treatment of patients with irritable bowel syndrome with constipation (“IBS-C”) or chronic idiopathic constipation (“CIC”), based on IQVIA data.
Source: Ironwood Pharmaceuticals
