Akebia Therapeutics (NASDAQ:AKBA) reported mixed fourth-quarter 2025 results, with revenue surpassing analyst forecasts while earnings per share fell short of expectations, as investors focused on improving commercial momentum and a stronger balance sheet.
Shares of the kidney-disease drug developer rose sharply in premarket trading following the release, reflecting optimism around revenue growth and cash position improvements despite the earnings miss.
Revenue growth driven by product momentum
Akebia generated fourth-quarter revenue of $57.6 million, exceeding consensus estimates of $56.18 million and representing a 23.9% increase compared with the same period a year earlier. Growth was primarily supported by continued demand for phosphate binder Auryxia alongside contributions from the commercial rollout of Vafseo.
For the full year 2025, total revenue climbed 47.4% to $236.2 million, underscoring accelerating commercialization efforts across the company’s kidney disease portfolio.
Earnings miss offsets otherwise improving fundamentals
The company reported a quarterly loss of $0.05 per share, missing analyst expectations of roughly break-even results and marking a significant negative earnings surprise.
Despite the EPS shortfall, Akebia reduced its net loss substantially, reporting a fourth-quarter net loss of $12.2 million compared with a $22.8 million loss in the prior-year period — an improvement of 46.5% that highlighted tighter cost control and operational efficiencies.
Balance sheet strengthens
Akebia ended 2025 with cash and cash equivalents of $184.8 million, up significantly from $51.9 million a year earlier, reinforcing liquidity as the company continues investing in commercialization and pipeline development.
Management pointed to the stronger financial position as evidence of progress toward sustainable growth.
CEO John Butler said, “Our revenue growth and improved cash position reflect our strategic efforts to enhance operational efficiency while driving demand for our key products.” He added that continued investment in research and development remains central to the company’s long-term strategy.
Market reaction and investor sentiment
Akebia shares gained nearly 10% in premarket trading following the announcement, suggesting investors prioritized revenue strength and improving fundamentals over the earnings miss. The stock remains near its 52-week lows after significant volatility over recent months, though analyst sentiment continues to point to potential upside.
Outlook
Looking ahead, Akebia expects gradual earnings improvement through 2026, with projections calling for positive EPS later in the year and revenue potentially reaching approximately $289 million for full-year 2026.
The company remains focused on expanding adoption of Vafseo while advancing its pipeline of therapies targeting kidney diseases.
Risks and considerations
Key risks facing the company include potential supply-chain disruptions, regulatory uncertainties tied to product approvals, competitive pressures in core markets and broader macroeconomic conditions that could weigh on healthcare spending.
Even so, management believes strengthening commercial execution and continued pipeline investment position Akebia for longer-term growth as demand for kidney disease treatments expands.