BOSTON — Ironwood Pharmaceuticals said it met its financial guidance for 2025, posting revenue of $296 million and GAAP net income of $24 million, and reaffirmed expectations for significantly higher earnings and cash flow in 2026 as it continues to grow LINZESS and advance its rare disease pipeline.
The company reported adjusted EBITDA of $138 million for full-year 2025 and said it ended the year with $215 million in cash and cash equivalents, positioning it to reduce debt and fund late-stage clinical development.
“In 2025, LINZESS delivered 11% EUTRx demand growth year-over-year, continuing to strengthen its position as the prescription market leader for the treatment of IBS-C and CIC,” said Tom McCourt, chief executive officer of Ironwood. He said disciplined expense management helped the company navigate pricing headwinds while generating $127 million in operating cash flow during the year.
For 2026, Ironwood reiterated guidance calling for U.S. LINZESS net sales of $1.125 billion to $1.175 billion, total revenue of $450 million to $475 million, and adjusted EBITDA of more than $300 million. The company said higher LINZESS net sales and continued cost discipline are expected to drive improved profitability and support pipeline investments.
LINZESS prescription demand rose 11% year over year in 2025, with more than 5.7 million unique patients treated since launch, according to the company. U.S. net sales declined year over year due to pricing and rebate dynamics tied to Medicare Part D changes, though Ironwood said underlying demand remained strong.
McCourt said the company remains focused on “maximizing LINZESS, advancing apraglutide and delivering sustained profits and cash flows.” Apraglutide is Ironwood’s once-weekly GLP-2 analog being developed for patients with short bowel syndrome with intestinal failure.
Ironwood said it has finalized key design elements with regulators for a confirmatory Phase 3 trial of apraglutide, known as STARS-2. The global, randomized, placebo-controlled study is expected to begin site initiations in the second quarter of 2026.
“We believe apraglutide has the potential to redefine the standard of care for patients living with SBS-IF,” McCourt said, adding that the company’s improved financial position provides a clear path to execute its strategy and evaluate options to maximize shareholder value.
During the fourth quarter, Ironwood generated $74.6 million in operating cash flow and reduced expenses year over year. The company also disclosed a legal settlement related to a licensing dispute, under which it paid $7.5 million in 2025 and expects to pay an additional $5.0 million by the end of 2026.
Ironwood said it enters 2026 with increased financial flexibility, a strengthened balance sheet, and multiple near- and mid-term catalysts tied to its commercial business and late-stage clinical development program.
