Keenova Q3 2026: XIAFLEX Jumps 82%, Guidance Raised

Keenova Therapeutics plc reported third quarter 2026 net sales from continuing operations of $550 million on 10 November 2026, a rise of $133 million, or 32%, over the same period a year earlier. Acthar Gel net sales reached $227 million, up 25%, while XIAFLEX net sales hit $164 million, an 82% increase. The company also raised its full-year pro forma net sales guidance to $2.00 billion to $2.025 billion from a prior range of $1.94 billion to $2.00 billion.

Context — why the raised guidance matters now

The quarter is the first full period in which Keenova carries XIAFLEX for all three months. The company closed its business combination with Endo LP on 31 July 2025, so the prior-year third quarter captured only two months of the acquired brand. That timing gap explains a large share of the reported 82% XIAFLEX jump and the 32% total sales increase, and it is why the comparison is not like-for-like.

Against that distorted base, the company's forward numbers carry more weight. Keenova now expects XIAFLEX net sales to grow 10% to 11% year over year, up from its earlier "high single digit" projection. That upgrade is the stated reason for the higher sales and earnings outlook.

Acthar Gel guidance was left unchanged at 20% to 22% growth. The company said the quarter's core-brand performance came from "increased demand and improved operational execution," attributing the strength to higher patient demand and commercial investment rather than a one-off item.

Merger integration is running ahead of schedule. Keenova realized $31 million of synergies in the quarter and now expects roughly $110 million of pre-tax synergies across 2026, keeping it on track for $150 million of annual pre-tax run-rate savings by the merger's three-year anniversary.

The broader picture is a company still absorbing a large acquisition while separating a former subsidiary. Keenova completed the spin-off of Par Health on 10 November 2025, and Par Health's results are now reported as discontinued operations, retroactively, across all periods shown.

Data — what the numbers show

Adjusted EBITDA from continuing operations was $233 million in the quarter, against $46 million a year earlier. On a GAAP basis, the loss from continuing operations narrowed to $96 million from $242 million. The improvement reflects the sales gain, the absence of $100 million of transaction-related compensation expense, $76 million lower professional fees tied to merger and integration work, and $52 million less non-cash amortization of inventory step-up.

Those gains were partly offset by a $151 million pre-tax loss on the divestiture of Percocet, plus a full quarter of Endo operating costs versus two months previously.

The product mix shifted. INOmax net sales slipped 3% to $57 million, and other products rose 5% to $83 million. License revenues jumped to $19 million from $6.7 million. The table below sets the quarter against the prior year.

Line item	Q3 2026	Q3 2025	Change
Acthar Gel	$226.5M	$181.4M	+25%
XIAFLEX	$163.7M	$90.1M	+82%
INOmax	$57.1M	$58.9M	-3%
Other products	$83.2M	$79.0M	+5%
License revenues	$19.0M	$6.7M	NM
Total	$549.5M	$416.1M	+32%

Through nine months, total net sales reached $1.535 billion versus $888 million a year earlier. The company's XIAFLEX growth target is measured against a fiscal 2025 base of $546.3 million, which combines Endo's $299.7 million for the pre-merger portion of that year and Keenova's $246.6 million for the post-merger portion.

Analysis — what it means for markets and sectors

Keenova sits in specialty branded therapeutics, where investor attention turns on durable demand for a small number of high-price brands and on pipeline expansion that extends exclusivity. The raised XIAFLEX outlook matters because the drug is the company's main growth lever and its clinical program is the path to a wider label.

Second-order effects land on the pipeline. Keenova is targeting a supplemental biologics license application to the FDA in the first quarter of 2027 for XIAFLEX in plantar fibromatosis, a condition with few approved options. It also began enrolling a Phase 3 study in hammer toe in August 2026. Both, if successful, widen the addressable patient pool without new manufacturing footprint, since the company already runs U.S. facilities in Louisiana, New Jersey, New York, Pennsylvania and Wisconsin.

The counter-argument is that the headline growth rates flatter the underlying trend. Stripping out the extra month of XIAFLEX and the merger's purchase-accounting effects, the organic picture is closer to the low-double-digit range the company now guides to. The $151 million Percocet divestiture loss is also a real cash and book hit that GAAP earnings still carry, even though management excludes it from Adjusted EBITDA.

On positioning, the story is a deleveraging and integration trade. Investors holding the name are effectively betting that overlap delivery stays ahead of plan and that the XIAFLEX label expansions convert. Skeptics point to the still-negative GAAP loss and the reliance on a narrow brand set.

Outlook — what to watch next

The clearest near-term catalyst is the plantar fibromatosis sBLA submission, which the company targets for the first quarter of 2027. A second is the hammer toe Phase 3, where enrollment began in August 2026 and the timeline depends on accrual. Third is the cadence of overlap realization, with $110 million expected for full-year 2026 against the $150 million three-year run-rate target.

Guidance itself is the level to track. Full-year pro forma net sales are guided to $2.00 billion to $2.025 billion, and pro forma Adjusted EBITDA to $750 million to $770 million, both raised from prior ranges of $1.94 billion to $2.00 billion and $715 million to $745 million respectively. The guidance excludes any future acquisition or divestiture activity.

Keenova does not provide a GAAP reconciliation for its forward-looking non-GAAP guidance, saying the reconciling items are too uncertain to estimate.

Frequently Asked Questions

What does the raised Keenova guidance mean for retail investors?

It signals management's confidence in its two core brands. The company lifted full-year pro forma net sales to $2.00 billion to $2.025 billion and pro forma Adjusted EBITDA to $750 million to $770 million. The upgrade rests on stronger expected XIAFLEX growth, now 10% to 11%, plus steady Acthar Gel demand. Note that guidance excludes future deal activity and carries no GAAP reconciliation.

Why did XIAFLEX net sales rise 82% in the quarter?

Two forces combined. Keenova closed its Endo merger on 31 July 2025, so the prior-year quarter included only two months of XIAFLEX sales, while the 2026 quarter captured all three. The company also cited increased demand in Peyronie's disease and higher net price. The growth rate therefore overstates the underlying trend relative to the low-double-digit full-year target.

What happens next for Keenova's pipeline?

The company is targeting a supplemental biologics license application to the FDA in the first quarter of 2027 for XIAFLEX in plantar fibromatosis. It also initiated enrollment in a Phase 3 study for hammer toe in August 2026. Approval of a new indication would widen the eligible patient population. The company has not disclosed specific filing terms or expected review timelines beyond the first-quarter 2027 submission target.

Bottom Line

Keenova raised full-year guidance on stronger XIAFLEX expectations, but the headline growth rates still reflect merger timing.

Disclaimer: This article is for informational purposes only and does not constitute investment advice. CFD trading carries high risk of capital loss.