Mirum's Heavy Dependence on Livmarli for Revenues Remains a Woe

Core Insights - Mirum Pharmaceuticals' lead product, Livmarli, is approved for treating cholestatic pruritus in patients with Alagille syndrome and certain patients with progressive familial intrahepatic cholestasis [1][2] - Livmarli's sales reached $213.3 million in 2024, marking a 50.4% year-over-year increase, although the company's heavy reliance on this drug raises concerns [2] - Mirum's stock has surged 83.2% over the past year, contrasting with an 8.5% decline in the industry [2] Product and Pipeline Developments - Livmarli is currently being evaluated in the phase III EXPAND study for treating pruritus in rare cholestatic conditions, with enrollment expected to complete in 2026 [3] - Mirum acquired Travere Therapeutics' bile acid products in August 2023, adding Cholbam and chenodiol tablets to its portfolio [3][4] - Ctexli (chenodiol) tablets were approved by the FDA in February 2025 for treating cerebrotendinous xanthomatosis, becoming the first approved treatment for this condition [4] Financial Performance and Concerns - Despite the growth from bile acid products, the company remains heavily dependent on Livmarli for revenue, which poses risks if sales do not meet expectations [4][9] - Disappointing results from the phase IIb EMBARK study for biliary atresia led to the discontinuation of the clinical study, highlighting potential pipeline setbacks [10] Market Position - Mirum currently holds a Zacks Rank 4 (Sell), indicating a less favorable market position compared to other biotech stocks like Gilead Sciences, Dynavax Technologies, and Arvinas, which have better rankings [11]