AstraZeneca reported that Wainua, its drug for transthyretin-mediated amyloid cardiomyopathy (ATTR-CM) developed with Ionis Pharmaceuticals, failed to outperform placebo in a pivotal trial. The company said the therapy did not reduce cardiovascular death and clinical events for patients with ATTR-CM, undercutting expectations for an expansion in a highly competitive cardiovascular market. Shares of AstraZeneca and Ionis fell sharply in early trading following the disclosure. The outcome represents a setback for AstraZeneca’s late-stage cardiology ambitions and narrows the path for antisense-led programs in cardiovascular amyloidosis. The trial failure also highlights the difficulty of translating advances into clear clinical benefit in ATTR-CM, where endpoints are stringent and competitive standards are rising across biopharma.