Altimmune (ALT) Q3 2026 earnings review
Altimmune's main liver trial is running, but its losses widen
Altimmune, a biotech developing a single drug for serious liver diseases, now spends heavily on its largest trial. Research spending rose 81% from a year ago because the final-stage study in fatty liver disease began enrolling patients. Cash and investments shrank by about $39 million, and the company sold no new shares. Chief executive Jerry Durso said Altimmune will meet US regulators in December to plan a final trial in alcohol use disorder.
| Research spending | $27.0M +81% from a year ago |
|---|---|
| Net loss | $31.6M $19.0M a year ago |
| Cash and investments | $480M $519M three months earlier |
| Trial timetable | Unchanged main liver results in 2029; FDA meeting in December |
⚖️ Verdict: ⚪ Neutral
The story is unchanged, because the extra spending pays for a trial Altimmune had already planned and funded. On the plus side, the alcohol program now has a date with the FDA. One caution: by our math, cash after debt lasts about 12 quarters at this pace, which reaches only late 2029, and costs are still climbing.
The question now is whether the cash lasts until the main liver results without another share sale. Spending may stop rising once enrollment ends, or a final alcohol trial outside the cash plan may add a second large bill. The trial design Altimmune reports after the December FDA meeting will start to show which.
🐂 Bull Case
Alcohol Program Gets a December FDA Meeting
Altimmune also tests pemvidutide, its experimental drug that targets two hormone receptors, in alcohol use disorder (AUD). Its 24-week RECLAIM trial met its main goal of fewer heavy drinking days in July. Those results then earned a late-breaking talk at the AASLD liver meeting.
The biotech has booked a December meeting with the FDA "to discuss the Phase 3 registrational program in AUD", the final trial needed for approval. That meeting turns a positive trial into a plan with a size and a cost. But the path still depends on what proof the FDA will accept.
What to watch: the trial design Altimmune reports after the December meeting. Its size will show what the alcohol program costs on top of the liver study.
Direct Spending on Pemvidutide More Than Doubles
PERFORMA is the global Phase 3 trial, the large final study needed for approval, of Altimmune's drug pemvidutide in MASH, a fatty liver disease. Chief executive Jerry Durso said the trial "is ramping up", and the research bill backs him.
- Direct pemvidutide costs: $20.3 million, from $11.6 million last quarter
- Same costs a year ago: $9.2 million
- Share of research spending going directly to the drug: 75%, from 62%
The biotech said PERFORMA and RESTORE, its trial in alcohol-related liver disease, drove the increase. A slow start would have delayed the 2029 results and burned cash while it waited for patients.
What to watch: the number of PERFORMA sites open and patients enrolled, missing from the release. Enrollment on schedule would support the 2029 date for results.
🐻 Bear Case
Cash Reaches 2029 Only If Costs Stop Rising
Altimmune has no product sales, so it runs on cash raised from share sales. Last quarter, management said that money would last through the 2029 results of PERFORMA, its final-stage fatty liver trial. In its favour, the biotech holds $480 million and sold no new shares this quarter.
Cash and investments fell by $38.6 million in the quarter. A $2.0 million drop in the market value of its investments explains part of that, so by our math the business used about $36.7 million.
- Cash after the $35 million loan: about $445 million, by our math
- Cash use per quarter in the first half: about $23 million
- Quarters of cash left at this pace: about 12, by our math
This cuts against the funded-to-2029 message, because spending has not stopped climbing. Research costs rose 45% from last quarter, and the trial has only begun to enroll. A final-stage alcohol trial, which the cash plan excludes, would add a second large bill.
What to watch: cash use in the fourth-quarter results. Above $40 million a quarter, the cash would last under three years, which may not reach the main results.
Dropout Rates From the Alcohol Trial Remain Unpublished
Altimmune presents pemvidutide, its experimental drug that targets two hormone receptors, as easy to tolerate. At the AASLD liver meeting it showed a poster on stomach side effects "Without Dose Titration", meaning without slowly building up the dose, in MASH, a fatty liver disease.
Its alcohol use disorder trial, RECLAIM, got a late-breaking talk at the same meeting. But the release gives no dropout rates for that trial, and last quarter management called them similar between drug and placebo without giving numbers. Dropouts matter because they shape how regulators and doctors judge a drug for heavy drinkers.
What to watch: RECLAIM dropout rates by dose, in a published presentation or the next results. They will show whether the alcohol program can claim good tolerability as well as an effect on drinking.
Risks this quarter didn't answer
Altimmune reported progress but no new numbers on four standing risks. Each carries weight because the biotech's future rests on one experimental drug, pemvidutide, now in a final-stage trial in MASH, a fatty liver disease.
- Final results: the 2029 PERFORMA biopsy results decide the MASH case, after the earlier Phase 2b study missed its scarring goal at 24 weeks; only those results will move this.
- Rival drugs: approved and late-stage GLP-1 drugs compete for the same patients; any head-to-head data or rival launch dates would move this.
- Biopsy variation: readers of liver biopsies can disagree, which blurs trial results; detail on how PERFORMA reads biopsies would move this.
- Trial scale: PERFORMA plans about 300 sites worldwide; a count of open sites and enrolled patients would move this.
👓 Other Themes
New Directors and a New Headquarters
In October, Altimmune added Peter Greenleaf and Alex Howarth to its board "to support its strategic evolution", without saying what that evolution involves. In November, the biotech moved its headquarters to Morristown, New Jersey, completing a relocation it announced in June. The release gives no cost figure for the move.
💲 Other KPIs
Overhead, or general and administrative spending, rose 47% from a year ago, its fastest pace this year. Altimmune cited higher pay and professional services. The line has run between $7.6 million and $8.7 million a quarter in 2026. It now equals about a third of research spending.
Interest income edged up 6.5% from last quarter, after rising 56% in the second quarter on the April share sale. By our math, cash and investments earned about 3.9% a year. The $35 million loan costs about 12.8% a year, so Altimmune pays a far steeper rate than it earns.
The share count behind per-share results grew 130% from a year ago, after two share sales this year. That is why the loss per share narrowed to $0.15 from $0.21, even as the net loss widened. Shares outstanding barely moved this quarter, at 194.5 million, so Altimmune made no large sale.
🔮 Guidance
Unchanged. Altimmune still plans the first main results from PERFORMA, its final-stage fatty liver trial, in 2029, and said the trial "is progressing as planned". Every quarter of delay would add another quarter of spending, because the biotech has no sales. Its net loss grew faster this quarter as the trial started.
New. Altimmune will meet the FDA in December to discuss a final-stage trial in alcohol use disorder. Last quarter, management said it would design and price that study after this meeting, then fund it in 2027. The date keeps that sequence on time.
Unchanged. Altimmune still expects first results from RESTORE, its trial in liver disease caused by alcohol, in the second half of 2027. Enrollment finished in August, and patients take the drug for 48 weeks, which sets the date.
❓ Key Questions
What were RECLAIM dropout rates on each dose?
Dropouts from side effects decide whether pemvidutide's tolerability claim carries over to heavy drinkers. Management called the rates similar between groups last quarter but has not published the numbers.
How many PERFORMA sites and patients are enrolled now?
The 2029 results depend on finishing enrollment on time across about 300 planned sites. A count would show whether the trial is on track before costs climb further.
What quarterly spending does the 2029 cash plan assume?
By our math, cash use reached about $37 million this quarter, and research costs keep rising. Readers need the pace behind the claim that cash lasts to the main results.
How will Altimmune pay for an alcohol Phase 3?
The cash plan leaves out a final-stage alcohol trial. The December FDA meeting sets its size, so Altimmune should say whether it plans debt, a royalty deal, a partner or new shares.
What strategic change do the new directors support?
Altimmune said it added two directors to support its strategic evolution but gave no detail. Readers should know whether that means a partnership, a new indication or a change in focus.