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Akero Therapeutics, Inc. (AKRO)·Q4 2024 Earnings Summary
Executive Summary
- Reported Q4 2024 and FY 2024 results with total operating expenses of $78.0M and net loss of $70.0M; cash, cash equivalents and short-term marketable securities were $743.1M as of December 31, 2024 .
- Bold clinical catalyst: reported an unprecedented, statistically significant reversal of compensated cirrhosis (F4) at Week 96 in the Phase 2b SYMMETRY study for patients treated with 50mg EFX, including 39% reversal in completers vs 15% placebo and 29% ITT vs ~12% placebo; noninvasive fibrosis and liver injury measures also improved .
- Strengthened balance sheet via a $402.5M upsized public offering closed on January 30, 2025; management now guides cash runway into 2028, extending prior guidance .
- Phase 3 SYNCHRONY program progressing: Real-World double-blind enrollment completed in January 2025; increased screening for Outcomes following January SYMMETRY readout; Histology 52-week results remain on track for H1 2027, Real-World topline on track for H1 2026 .
- Wall Street consensus (S&P Global) for Q4 2024 revenue/EPS was unavailable due to data access limits; cannot assess beats/misses relative to estimates.*
What Went Well and What Went Wrong
What Went Well
- Bold efficacy signal in compensated cirrhosis (F4): 39% reversal with 50mg EFX at Week 96 among completers vs 15% placebo; ITT 29% vs ~12% placebo; in non‑GLP‑1 baseline subgroup, 45% reversal vs 17% placebo, supporting effect attribution to EFX .
- Management tone confident: “These exciting results… show EFX’s potential to improve outcomes… for those with compensated cirrhosis” – Andrew Cheng, M.D., Ph.D., CEO .
- Execution in Phase 3: Real‑World double‑blind enrollment completed; Outcomes seeing increased screening post‑readout; Histology and Real‑World timelines reaffirmed .
What Went Wrong
- Operating expenses elevated: Q4 2024 total OpEx $78.0M vs $61.9M in Q4 2023; driver was higher R&D tied to Phase 2b SYMMETRY and Phase 3 SYNCHRONY studies, plus personnel costs; net loss $70.0M vs $55.2M prior year quarter .
- Interest expense modestly higher year over year in Q4 ($1.2M vs $0.9M), adding to net loss despite higher interest income ($9.2M vs $7.6M) .
- No product revenue disclosed; the P&L reflects R&D‑heavy burn typical of clinical‑stage companies, necessitating continued access to capital (offering closed Jan 30, 2025) .
Financial Results
KPIs (Clinical, Q4 2024 focus):
Segment breakdown: Not applicable; company has no disclosed commercial segments; financials presented as consolidated R&D and G&A .
Margins: Not applicable due to absence of product revenue; the company reports operating expenses and net loss .
Guidance Changes
Earnings Call Themes & Trends
Management Commentary
- “The preliminary topline results… showed an unprecedented, statistically significant reversal of compensated cirrhosis due to MASH in patients treated with 50mg EFX for 96 weeks.” – Andrew Cheng, M.D., Ph.D., President and CEO .
- “We remain committed to advancing EFX as a potential therapeutic breakthrough for individuals living with advanced MASH and look forward to building upon this momentum as we progress our Phase 3 SYNCHRONY program.” – Andrew Cheng, M.D., Ph.D. .
- External PI perspective: “Now we have reason to be optimistic about the future potential of EFX… as a much‑needed treatment for cirrhosis, if approved.” – Mazen Nourredin, M.D., Houston Methodist Hospital (SYMMETRY PI) .
Q&A Highlights
- No Q4 2024 earnings call transcript was available in the document set; the company did host an investor webcast on January 27, 2025 to discuss SYMMETRY Week 96 results .
- Guidance clarifications in written materials: timelines reaffirmed for Histology (H1 2027) and Real‑World (H1 2026); Outcomes enrollment momentum noted post‑readout .
Estimates Context
- Wall Street consensus estimates via S&P Global for Q4 2024 revenue and EPS were unavailable due to access limits, so we cannot provide a beat/miss assessment.*
- Given elevated R&D linked to Phase 3 activities and January efficacy readout, Street models may reassess R&D run‑rate and cash runway assumptions; no explicit non‑GAAP financial guidance was provided in company materials .
Key Takeaways for Investors
- Bold efficacy in F4 compensated cirrhosis: 39% reversal (completers) and 29% (ITT) for 50mg EFX vs placebo, with corroborating noninvasive improvements – a clear differentiation catalyst in MASH cirrhosis .
- Execution strength: Real‑World double‑blind enrollment completed; Outcomes screening increasing; Histology and Real‑World timelines intact, maintaining line‑of‑sight to pivotal Phase 3 milestones .
- Capital secured: $402.5M offering closed; runway extended into 2028, reducing near‑term financing risk amid Phase 3 spend .
- R&D burn remains material: Q4 OpEx $78.0M and net loss $70.0M; higher spend driven by Phase 2b/3 programs and personnel, aligning with development cadence .
- Trading lens: Near‑term narrative likely anchored by SYMMETRY durability and Outcomes enrollment cadence; conference presence and publications add credibility to the clinical thesis .
- Risk management: No product revenue disclosed; reliance on capital markets persists until approval; regulatory timelines (Histology H1 2027, Real‑World H1 2026) frame key de‑risking events .
- Watch for data flow: Additional analyses/publications, Phase 3 operational updates, and Real‑World safety/tolerability readout in H1 2026 are the next catalysts .
*Estimates unavailable: Values that would normally be retrieved from S&P Global were not accessible at this time.