Viridian Therapeutics’ elegrobart phase III readout in active thyroid eye disease met its primary endpoint, but the stock fell sharply after investors questioned the overall commercial positioning versus existing IGF-1R competitor Tepezza. In the REVEAL-1 trial of 132 patients, the proptosis responder rate at week 24 was 54% with monthly dosing versus 18% with placebo. Analysts flagged investor debate around commercial feasibility, including cross-trial comparability and whether dosing convenience will translate into market share in a crowded autoimmune eye setting. Viridian also positioned its other IGF-1R antibody, veligrotug, as potentially stronger based on earlier comparisons. The mixed market reaction highlights how late-stage success is increasingly judged not just by endpoints, but by how clearly the asset can win against already approved incumbents.