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Mirum Gains 35% in 3 Months: How Should You Play the Stock?

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Key Takeaways

  • MIRM surged 35% in 3 months, outpacing the industry, sector and the broader market on strong product sales.
  • Livmarli sales rose 71% in Q1 2025, fueling revenue growth and boosting MIRM's full-year guidance.
  • MIRM eyes pipeline expansion with volixibat studies and a planned Fragile X syndrome trial in 2025.

Mirum Pharmaceuticals (MIRM - Free Report) has delivered a stellar performance over the past three months. Shares of the company have rallied 35% compared with the industry’s rise of 6.9%. The stock has also outperformed the sector and the S&P 500 index in the said timeframe.

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The company’s lead product, Livmarli (maralixibat), has experienced strong sales uptake since its approval and global launch. The drug contributes the majority of Mirum’s revenues. The outperformance can be mainly attributed to the sales performance of Livmarli as well as the company’s other commercial activities.

Let us take a look at what’s happening with Mirum.

Strong Livmarli Sales Aid MIRM Stock

The company’s lead product, Livmarli (maralixibat), an orally administered ileal bile acid transporter (“IBAT”) inhibitor, is approved for the treatment of cholestatic pruritus in patients with Alagille syndrome (ALGS) worldwide.

The drug is also approved for treating certain patients with progressive familial intrahepatic cholestasis (PFIC) in the United States and Europe.

Livmarli’s net product sales were $73.2 million in the first quarter of 2025, reflecting an increase of 71% year over year. The continued demand for Livmarli is driving the company’s top line and the momentum is expected to continue in the remainder of 2025.

In April, the FDA approved a new tablet formulation of Livmarli for treating cholestatic pruritus in patients with Alagille syndrome and progressive familial intrahepatic cholestasis. The approval for oral tablets is likely to offer convenience for the older patients.

Mirum is also evaluating Livmarli in the phase III EXPAND study for treating pruritus in rare cholestatic conditions. Enrollment in the study is expected to be completed in 2026.

MIRM's Other Commercial Products Maintain Momentum

Mirum acquired Travere Therapeutics’ bile acid products in August 2023, which added the latter’s Cholbam capsules and Ctexli tablets to its portfolio of commercialized drugs. Revenues from bile acid products are also aiding Mirum’s top-line growth.

The FDA approved Ctexli tablets, a bile acid, for the treatment of adults with cerebrotendinous xanthomatosis in February 2025. Following the nod, Ctexli became the first and only treatment to be approved for this rare, progressive and debilitating disease. Cholbam is approved for treating bile acid synthesis disorders and Zellweger spectrum disorders.

Net product sales of bile acid products, comprising Cholbam and Ctexli tablets, were $38.4 million in the first quarter of 2025, reflecting an increase of 47% year over year.

Owing to the strong demand for its commercial products, Mirum raised its revenue guidance for 2025. The company now expects revenues to be in the range of $435-$450 million in 2025, compared with the earlier projection of $420-$435 million.

MIRM's Other Pipeline Updates

Mirum’s lead pipeline candidate, volixibat, is currently being evaluated in two phase IIb studies for treating patients with primary biliary cholangitis (the VANTAGE study) and primary sclerosing cholangitis (the VISTAS study).

Enrollment in the VISTAS study is expected to be completed later in the third quarter of 2025, with top-line data expected to be announced in the second quarter of 2026. The company expects to complete enrollment in the VANTAGE study in 2026.

Mirum also plans to initiate a phase II study on its recently in-licensed PDE4D inhibitor, MRM-3379, for treating Fragile X syndrome later in 2025.

MIRM's High Dependence on Livmarli

Though revenues from bile acid products are adding to Mirum’s top-line growth, the company remains heavily dependent on Livmarli for its top-line growth. Any regulatory setback for the drug could hurt the stock.

Growing competition also remains a concern. The company faces substantial competition from Albireo AB, now part of Ipsen, which markets Bylvay (odevixibat), also an IBAT inhibitor.

Bylvay is considered the most direct competitor for Livmarli in the PFIC and ALGS markets. Both medicines work by inhibiting IBAT to reduce serum bile acid levels. This is likely to induce acute competition for Livmarli, which is a concern.

MIRM's Valuation & Estimates

Going by the price/book ratio, MIRM’s shares currently trade at 11.21x trailing book value, higher than the industry’s average of 3.08 and its mean of 5.91.

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The Zacks Consensus Estimate for its 2025 loss per share has narrowed from $1.14 to $1.13 over the past 60 days. During the same time frame, loss per share estimates for 2026 have widened from 36 cents to 48 cents.

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Image Source: Zacks Investment Research

Conclusion

Mirum’s recent rally has been positive. Also, the robust sales performance of Livmarli and its bile acid products should help the stock gain further and drive upward momentum while meeting investors’ expectations.

However, competition from established players remains a major concern for Mirum. These companies have huge resources at their disposal, providing them with more commercial exposure. Failure in ongoing pipeline studies will be detrimental to MIRM’s stock.

While Mirum’s pipeline is in mid-stage development and progressing well, any adverse outcome will be a huge setback for the company. We would advise investors to wait for additional data readouts and the successful completion of the studies. Also, the successful commercialization of Livmarli holds the key amid competition. For those already owning the stock, staying invested as of now would be a prudent move. Any positive data announcement from the ongoing studies may provide an impetus to the stock.

MIRM's Zacks Rank & Stocks to Consider

Mirum currently carries a Zacks Rank #3 (Hold).

Some better-ranked stocks from the biotech sector are Arvinas (ARVN - Free Report) and Akero Therapeutics (AKRO - Free Report) , each sporting a Zacks Rank #1 (Strong Buy) at present. You can see the complete list of today’s Zacks #1 Rank stocks here.

In the past 60 days, estimates for Arvinas’ 2025 loss per share have improved from $1.60 to $1.51. Loss per share estimates for 2026 have narrowed from $3.28 to $2.98 during the same period. ARVN stock has plunged 60.4% year to date.

Arvinas’ earnings beat estimates in each of the trailing four quarters, delivering an average surprise of 82.09%.

In the past 60 days, estimates for Akero Therapeutics’ 2025 loss per share have improved from $4.00 to $3.96. Loss per share estimates for 2026 have narrowed from $4.34 to $4.27 during the same period. Year to date, shares of AKRO have surged 92.7%.

Akero Therapeutics’ earnings beat estimates in three of the trailing four quarters, while missing the same on the remaining occasion, the average surprise being 48.90%.


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