Novartis disclosed that its neuromuscular candidate delpacibart etedesiran failed a pivotal Phase III trial, delivering a major blow to the company’s late-stage execution. In the HARBOR study (NCT06411288), the therapy missed the primary endpoint, failing to show a statistically significant improvement versus placebo in video hand opening time (vHOT) through week 54. The Phase III miss is also amplifying scrutiny of Novartis’ acquisition strategy. Reporting on the market reaction, Reuters cited criticism from Artisan Partners managing director M. David Samra, who urged board-level changes and questioned the value impact of prior deals. Novartis previously targeted neuroscience expansion via its $12 billion acquisition of Avidity Partners, where delpacibart etedesiran was linked to AOC (Antibody Oligonucleotide Conjugates) RNA therapeutics. With the HARBOR outcome now public, investors will likely reprice the remaining confidence in Novartis’ AOC pathway and associated neuroscience roadmap.