Ionis CEO: $3B Tryngolza Opportunity and the Next Wave of RNA Drugs

Ionis CEO Dr. Brett Monia explains why the company may be entering one of the most important stretches in its history, with Tryngolza facing a June 30 FDA decision in severe hypertriglyceridemia and Pelacarsen's HORIZON outcomes data expected soon. He also discusses Ionis' shift from discovery partner to fully integrated biotech, its growing antisense and siRNA platform, CNS ambitions, and the path toward cash-flow breakeven in 2028.

Topics covered:
• Tryngolza/Olezarsen and the severe hypertriglyceridemia opportunity
• The 85% pancreatitis event reduction shown in Phase 3 data
• Why Ionis raised U.S. peak sales guidance to $3 billion-plus
• Pelacarsen, Lp(a), and the HORIZON cardiovascular outcomes trial
• Competition from siRNA drugs and Ionis' next-generation follow-on molecules
• CNS programs, blood-brain-barrier delivery, and the Bicycle Therapeutics partnership
• Ionis' transition from licensing-focused R&D shop to integrated biotech
• Cash-flow breakeven goals, pipeline readouts, and what investors may be missing

Dr. Brett Monia, CEO of Ionis Pharmaceuticals, joins Karl Thiel for this interview.

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